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"content": "\u003cp>Health advocates are expressing frustration after a bill that would have required warning labels on sugary drinks died in Sacramento.\u003c/p>\n\u003cp>The state's Senate Health Committee voted 4-1 on Wednesday afternoon, but the bill needed five votes to advance. In addition to the five senators who voted, another four were present in the hearing room but did not vote.\u003c/p>\n\u003cp>\"This is really a tragedy for California,\" said Harold Goldstein, executive director for the California Center for Public Health Advocacy, sponsor of\u003ca title=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB203\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB203\" target=\"_blank\"> SB203\u003c/a>. Last year a similar bill made it through the Senate before \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/18/california-assembly-rejects-sugary-drink-warning-label/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/18/california-assembly-rejects-sugary-drink-warning-label/\" target=\"_blank\">stalling in the Assembly\u003c/a>.\u003c/p>\n\u003cp>Along with many doctors, Goldstein says sugary drinks are a \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/11/10/ucsf-initiative-links-sugar-science-to-your-health/\" href=\"http://ww2.kqed.org/stateofhealth/2014/11/10/ucsf-initiative-links-sugar-science-to-your-health/\" target=\"_blank\">major driver of obesity and diabetes\u003c/a>. The bill called for a label on most drinks with more than 75 calories per 12-ounce serving. This would include regular soda drinks. (Diet drinks were not covered, since they have no sugar and very few, if any, calories.)\u003c/p>\n\u003cp>The proposed label said: “STATE OF CALIFORNIA SAFETY WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Such a warning label would spur some people to switch to healthier drinks, Goldstein said. He faulted the senators who did not vote for the bill, effectively killing it.\u003c/p>\n\u003cp>\"The members of the Senate Health Committee, whose responsibility is to protect the health of Californians, chose instead to side with the beverage industry to keep scientifically-based information about the harmful effects of soda and other sugary drinks away from California consumers.”\u003c/p>\n\u003cp>Bob Achermann, executive director with CalBev, was pleased with the committee's decision. “Addressing obesity and diabetes is more complicated than a warning label,\" he said in a statement. \"The best way to promote balanced lifestyles is through fact-based information, not sensational safety warning labels.\"\u003c/p>\n\u003cp>Darcel Harris Lee, president and CEO of the California Black Health Network, testified in support of the bill before the committee. She called the vote \"disappointing,\" but said the bill would be back. She compared the advocacy her group is doing with that of the organization's efforts to put warning labels on cigarette packages decades ago.\u003c/p>\n\u003cp>\"I truly believe we have to continue this fight,\" she said. \"I'm not discouraged, I'm not deterred. We just continue this fight, and it is going to happen.\"\u003c/p>\n\u003cp>Sen. Bill Monning (D-Carmel), the author of the bill, also said he was not deterred.\u003c/p>\n\u003cp>“The scientific evidence of the proven adverse health impacts of sugar-sweetened beverages demands a health warning label, and it is only a matter of time before California enacts legislation that informs individuals about healthful beverage choices.”\u003c/p>\n\u003cp>Here's a list of how the committee members voted:\u003c/p>\n\u003cp>\u003cstrong>Yes:\u003c/strong>\u003c/p>\n\u003cp>Sen. Holly Mitchell (D-Los Angeles)\u003c/p>\n\u003cp>Sen. Bill Monning (D-Carmel)\u003c/p>\n\u003cp>Sen. Richard Pan (D-Sacramento)\u003c/p>\n\u003cp>Sen. Lois Wolk (D-Davis)\u003c/p>\n\u003cp>\u003cstrong>No:\u003c/strong>\u003c/p>\n\u003cp>Sen. Jim Nielsen, (R-Roseville)\u003c/p>\n\u003cp>\u003cstrong>Not voting/Abstain:\u003c/strong>\u003c/p>\n\u003cp>Sen. Ed Hernandez (D-West Covina),\u003c/p>\n\u003cp>Sen. Janet Nguyen (R-Santa Ana)\u003c/p>\n\u003cp>Sen. Isadore Hall (D-San Pedro)\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Sen. Richard Roth (D-Riverside)\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Health advocates are expressing frustration after a bill that would have required warning labels on sugary drinks died in Sacramento.\u003c/p>\n\u003cp>The state's Senate Health Committee voted 4-1 on Wednesday afternoon, but the bill needed five votes to advance. In addition to the five senators who voted, another four were present in the hearing room but did not vote.\u003c/p>\n\u003cp>\"This is really a tragedy for California,\" said Harold Goldstein, executive director for the California Center for Public Health Advocacy, sponsor of\u003ca title=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB203\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB203\" target=\"_blank\"> SB203\u003c/a>. Last year a similar bill made it through the Senate before \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/18/california-assembly-rejects-sugary-drink-warning-label/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/18/california-assembly-rejects-sugary-drink-warning-label/\" target=\"_blank\">stalling in the Assembly\u003c/a>.\u003c/p>\n\u003cp>Along with many doctors, Goldstein says sugary drinks are a \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/11/10/ucsf-initiative-links-sugar-science-to-your-health/\" href=\"http://ww2.kqed.org/stateofhealth/2014/11/10/ucsf-initiative-links-sugar-science-to-your-health/\" target=\"_blank\">major driver of obesity and diabetes\u003c/a>. The bill called for a label on most drinks with more than 75 calories per 12-ounce serving. This would include regular soda drinks. (Diet drinks were not covered, since they have no sugar and very few, if any, calories.)\u003c/p>\n\u003cp>The proposed label said: “STATE OF CALIFORNIA SAFETY WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Such a warning label would spur some people to switch to healthier drinks, Goldstein said. He faulted the senators who did not vote for the bill, effectively killing it.\u003c/p>\n\u003cp>\"The members of the Senate Health Committee, whose responsibility is to protect the health of Californians, chose instead to side with the beverage industry to keep scientifically-based information about the harmful effects of soda and other sugary drinks away from California consumers.”\u003c/p>\n\u003cp>Bob Achermann, executive director with CalBev, was pleased with the committee's decision. “Addressing obesity and diabetes is more complicated than a warning label,\" he said in a statement. \"The best way to promote balanced lifestyles is through fact-based information, not sensational safety warning labels.\"\u003c/p>\n\u003cp>Darcel Harris Lee, president and CEO of the California Black Health Network, testified in support of the bill before the committee. She called the vote \"disappointing,\" but said the bill would be back. She compared the advocacy her group is doing with that of the organization's efforts to put warning labels on cigarette packages decades ago.\u003c/p>\n\u003cp>\"I truly believe we have to continue this fight,\" she said. \"I'm not discouraged, I'm not deterred. We just continue this fight, and it is going to happen.\"\u003c/p>\n\u003cp>Sen. Bill Monning (D-Carmel), the author of the bill, also said he was not deterred.\u003c/p>\n\u003cp>“The scientific evidence of the proven adverse health impacts of sugar-sweetened beverages demands a health warning label, and it is only a matter of time before California enacts legislation that informs individuals about healthful beverage choices.”\u003c/p>\n\u003cp>Here's a list of how the committee members voted:\u003c/p>\n\u003cp>\u003cstrong>Yes:\u003c/strong>\u003c/p>\n\u003cp>Sen. Holly Mitchell (D-Los Angeles)\u003c/p>\n\u003cp>Sen. Bill Monning (D-Carmel)\u003c/p>\n\u003cp>Sen. Richard Pan (D-Sacramento)\u003c/p>\n\u003cp>Sen. Lois Wolk (D-Davis)\u003c/p>\n\u003cp>\u003cstrong>No:\u003c/strong>\u003c/p>\n\u003cp>Sen. Jim Nielsen, (R-Roseville)\u003c/p>\n\u003cp>\u003cstrong>Not voting/Abstain:\u003c/strong>\u003c/p>\n\u003cp>Sen. Ed Hernandez (D-West Covina),\u003c/p>\n\u003cp>Sen. Janet Nguyen (R-Santa Ana)\u003c/p>\n\u003cp>Sen. Isadore Hall (D-San Pedro)\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Sen. Richard Roth (D-Riverside)\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Vaccine Bill Approved in Key Hearing",
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"content": "\u003cfigure id=\"attachment_25005\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS1369_IMG_1902-e1429575505514.jpg\">\u003cimg class=\"size-large wp-image-25005\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS1369_IMG_1902-640x480.jpg\" alt=\"(Craig Miller/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Craig Miller/KQED) \u003ccite>(Craig Miller/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A controversial bill that would require vaccination for nearly all California children to attend school -- both public and private -- cleared the Senate Education Committee on Wednesday.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The bill \"has a long way to go.\" \u003c/aside>\n\u003cp>The committee voted 7-2 on the bill, co-authored by Sens. Richard Pan (D-Sacramento) and Ben Allen (D-Santa Monica). Both Democrats and Republicans supported the bill.\u003c/p>\n\u003cp>\"It's a strong sign that people want to be sure that we protect our kids, protect our schools and protect our communities from these preventable diseases,\" Pan said of Wednesday's vote.\u003c!--more-->\u003c/p>\n\u003cp>It was the bill's second hearing in a week by the committee. Last Wednesday, hundreds of people voiced their opposition to the bill, and it looked like the committee would kill it. Instead, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/04/15/vaccine-exemption-bill-stalls-in-sacramento-vote-next-week/\" href=\"http://ww2.kqed.org/stateofhealth/2015/04/15/vaccine-exemption-bill-stalls-in-sacramento-vote-next-week/\" target=\"_blank\">Pan and Allen asked to hold the bill\u003c/a> and crafted amendments letting families that opt out of vaccines homeschool their children together and allowing students seek independent study.\u003c/p>\n\u003cp>While the committee backed the bill's advance, chairwoman Sen. Carol Liu (D-Glendale) noted the bill \"still has a long way to go\" and hinted that she wasn't completely swayed that the proposed amendments are sufficient.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"In terms of public health, it's necessary,\" she said in reference to the bill, \"but I am concerned about the rights of our parents.\"\u003c/p>\n\u003cp>Opponents vowed to continue their fight. The bill now heads to the Senate Judiciary Committee for a hearing next week as part of a long legislative process. \u003ca title=\"http://www.vaccinatecalifornia.org/endorsements2\" href=\"http://www.vaccinatecalifornia.org/endorsements2\" target=\"_blank\">A long list\u003c/a> of health groups and school districts back the bill.\u003c/p>\n\u003cp>\"We will continue to show our strength, and we will continue to educate lawmakers and the public about why this is a bad bill,\" said Jean Keese, a spokeswoman for the California Coalition for Health Choice.\u003c/p>\n\u003cp>The proposal was among several drafted across the nation in the wake of a measles outbreak that started at Disneyland and sickened more than 100 people in the U.S. and Mexico.\u003c/p>\n\u003cp>It would eliminate California's personal-belief and religious exemptions so unvaccinated children would not be able to attend public or private schools. Medical waivers would only be available for children who have health problems.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The Associated Press contributed to this report.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_25005\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS1369_IMG_1902-e1429575505514.jpg\">\u003cimg class=\"size-large wp-image-25005\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS1369_IMG_1902-640x480.jpg\" alt=\"(Craig Miller/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Craig Miller/KQED) \u003ccite>(Craig Miller/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A controversial bill that would require vaccination for nearly all California children to attend school -- both public and private -- cleared the Senate Education Committee on Wednesday.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The bill \"has a long way to go.\" \u003c/aside>\n\u003cp>The committee voted 7-2 on the bill, co-authored by Sens. Richard Pan (D-Sacramento) and Ben Allen (D-Santa Monica). Both Democrats and Republicans supported the bill.\u003c/p>\n\u003cp>\"It's a strong sign that people want to be sure that we protect our kids, protect our schools and protect our communities from these preventable diseases,\" Pan said of Wednesday's vote.\u003c!--more-->\u003c/p>\n\u003cp>It was the bill's second hearing in a week by the committee. Last Wednesday, hundreds of people voiced their opposition to the bill, and it looked like the committee would kill it. Instead, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/04/15/vaccine-exemption-bill-stalls-in-sacramento-vote-next-week/\" href=\"http://ww2.kqed.org/stateofhealth/2015/04/15/vaccine-exemption-bill-stalls-in-sacramento-vote-next-week/\" target=\"_blank\">Pan and Allen asked to hold the bill\u003c/a> and crafted amendments letting families that opt out of vaccines homeschool their children together and allowing students seek independent study.\u003c/p>\n\u003cp>While the committee backed the bill's advance, chairwoman Sen. Carol Liu (D-Glendale) noted the bill \"still has a long way to go\" and hinted that she wasn't completely swayed that the proposed amendments are sufficient.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"In terms of public health, it's necessary,\" she said in reference to the bill, \"but I am concerned about the rights of our parents.\"\u003c/p>\n\u003cp>Opponents vowed to continue their fight. The bill now heads to the Senate Judiciary Committee for a hearing next week as part of a long legislative process. \u003ca title=\"http://www.vaccinatecalifornia.org/endorsements2\" href=\"http://www.vaccinatecalifornia.org/endorsements2\" target=\"_blank\">A long list\u003c/a> of health groups and school districts back the bill.\u003c/p>\n\u003cp>\"We will continue to show our strength, and we will continue to educate lawmakers and the public about why this is a bad bill,\" said Jean Keese, a spokeswoman for the California Coalition for Health Choice.\u003c/p>\n\u003cp>The proposal was among several drafted across the nation in the wake of a measles outbreak that started at Disneyland and sickened more than 100 people in the U.S. and Mexico.\u003c/p>\n\u003cp>It would eliminate California's personal-belief and religious exemptions so unvaccinated children would not be able to attend public or private schools. Medical waivers would only be available for children who have health problems.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The Associated Press contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Death in Secret: California's Underground World of Assisted Suicide",
"title": "Death in Secret: California's Underground World of Assisted Suicide",
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"content": "\u003cfigure id=\"attachment_25019\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/2.5.2011.2-e1429662884614.jpg\">\u003cimg class=\"size-large wp-image-25019\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/2.5.2011.2-640x480.jpg\" alt=\"When J.D. Arnold was dying of stomach cancer in 2011, his wife says doctors would only talk about death in euphemisms. (Photo: Hope Arnold)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">When J.D. Falk was dying of stomach cancer in 2011, his wife says doctors would only talk about death in euphemisms. (Photo: Hope Arnold)\u003c/figcaption>\u003c/figure>\n\u003cp>Physician-assisted suicide is illegal in California. But that doesn’t mean it doesn’t happen. Sick patients sometimes ask for help in hastening their deaths, and some doctors will explain, vaguely, how to do it.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“I remember standing there with syringes in my hand. Just standing there, with my hands shaking, and I was all alone.\" \u003c/aside>\n\u003cp>This leads to bizarre, veiled conversations between medical professionals who want to help, but also want to avoid prosecution, and overwhelmed family members who are left to interpret euphemisms at one of the most confusing times of their lives.\u003c/p>\n\u003cp>That’s what still frustrates Hope Arnold. She says throughout the 10 months her husband J.D. Falk was being treated for stomach cancer in 2011, no one would talk straight with them.\u003c/p>\n\u003cp>“All the nurses, all the doctors,\" says Hope, \"everybody we ever interacted with, no one said, ‘You’re dying.’ ”\u003c!--more-->\u003c/p>\n\u003cp>Until finally, one doctor did. And that’s when J.D. started to plan. He summoned his extended family. And Hope made arrangements for him to come home on hospice.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The day he was discharged from the hospital, Hope was dropping off some paperwork when she bumped into one of J.D.’s doctors.\u003c/p>\n\u003cp>“He hugged me and asked me how I was holding up,” she says. “And then he handed me a bottle of liquid morphine. He said, ‘You might need it.’ ”\u003c/p>\n\u003cp>Hope says she handed the bottle back. She told the doctor the hospice was going to drop off a machine that would administer J.D.’s pain medication automatically.\u003c/p>\n\u003cp>“And he looked at me,\" she says, \"and he held my gaze for a second. And he put it back in my hand and he said, ‘You Might. Need it.’”\u003c/p>\n\u003cp>She slipped the vial into her purse.\u003c/p>\n\u003cp>“When I got home, it hit me like a ton of bricks,” Hope remembers. “And I said to J.D., 'I think he may have given this to me so I can give you an overdose.' And he said, 'Maybe.' And then we didn’t talk about it anymore.”\u003c/p>\n\u003cp>Over the next couple days, J.D. deteriorated quickly. Hope says the hospice nurse offered another euphemism.\u003c/p>\n\u003cp>“He said, ‘He’s showing signs of imminence.’ ”\u003c/p>\n\u003cfigure id=\"attachment_25036\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/9.12.2009-1a.jpg\">\u003cimg class=\"size-medium wp-image-25036\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/9.12.2009-1a-300x288.jpg\" alt=\"Hope and J.D. Falk, on their wedding day. (Photo: Hope Arnold)\" width=\"300\" height=\"288\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Hope and J.D. Falk, on their wedding day. (Photo: Kelly Dunsford)\u003c/figcaption>\u003c/figure>\n\u003cp>Hope worried that J.D. was in a lot of pain. But she couldn’t tell. She was afraid that if she asked, it would betray the thoughts she was having about that extra vial of morphine.\u003c/p>\n\u003cp>“I couldn’t ask the nurse that,” Hope says. “I couldn’t ask anybody anything.”\u003c/p>\n\u003cp>In the end, she didn’t do it.\u003c/p>\n\u003cp>“J.D. never told me, 'I do want you to give me too much morphine,' \" Hope says. \"Actually, I don’t know whether or not he wanted that. That’s not the point. The point was nobody could talk about it.”\u003c/p>\n\u003cp>People don’t talk about it, but it’s happening. Just over 3 percent of U.S. doctors say they have written a prescription for life-ending medication, according to an \u003ca title=\"http://www.nejm.org/doi/full/10.1056/NEJM199804233381706#t=articleResults\" href=\"http://www.nejm.org/doi/full/10.1056/NEJM199804233381706#t=articleResults\" target=\"_blank\">anonymous survey\u003c/a> published in the New England Journal of Medicine. Almost 5 percent of doctors reported giving a patient a lethal injection.\u003c/p>\n\u003cp>\u003ca title=\"http://archinte.jamanetwork.com/article.aspx?articleid=214736#ira10015t4\" href=\"http://archinte.jamanetwork.com/article.aspx?articleid=214736#ira10015t4\" target=\"_blank\">Other studies\u003c/a> suggest oncologists, and doctors on the West Coast, are more likely to be asked for life-ending medication, or euthanasia, in which the doctor administers the lethal dose.\u003c/p>\n\u003cp>“Those practices are undercover, they are covert,” says Barbara Coombs Lee, president of Compassion and Choices, an advocacy group that is backing legislation in California to make it legal for doctors to prescribe lethal medication to terminally-ill patients who request it.\u003c/p>\n\u003cp>“To the degree that patients are part of the decision-making,\" Coombs Lee says, \"it is by winks and nods.”\u003c/p>\n\u003cp>Her organization actually guides dying patients how to get around current law.\u003c/p>\n\u003cp>“We talk with people about how they might broach the subject with their physicians,\" she says, \"and quite frankly, how to play the wink-and-nod game in a way that doesn’t jeopardize their physician.”\u003c/p>\n\u003cp>It’s a game Laura Bennett is all too familiar with. (Laura’s name has been changed to protect her privacy.) Laura lived in San Francisco during the 1980s and watched one friend after another die of AIDS.\u003c/p>\n\u003cp>“The guys would have fungus everywhere,\" she recounts. \"Horrible diarrheas, emaciation. “It looked like concentration camp pictures.”\u003c/p>\n\u003cp>A lot of the guys begged for lethal drugs to end their suffering. Laura and her friends figured out which doctors were willing to help.\u003c/p>\n\u003cp>“We would tell each other, ‘This is the doctor,'\" she says. \"'They’re going to tell you how much is too much to give, and then they’re going to give you too much.'\"\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/202083156\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>Though Laura witnessed many deaths hastened in this way, she says she never injected the drugs herself. Her time would come 20 years later when her husband John was dying of throat cancer. (John’s name has also been changed).\u003c/p>\n\u003cp>Some of his symptoms were brutal.\u003c/p>\n\u003cp>“It was like a horror movie,” Laura says, recalling the tumors all over John’s neck. They would fill with blood, she says, and sometimes burst.\u003c/p>\n\u003cp>“There’d be blood on the walls, on the mirror, everywhere,\" Laura recounts, \"and I’d be trying to keep him from drowning in it because it’d be going down his trach. And he’d be panicking.”\u003c/p>\n\u003cp>John was warned his death might be ugly. He might choke. He might have a seizure. More than anything, Laura says, John was afraid of dying in a hospital, hooked up to machines, powerless.\u003c/p>\n\u003cp>“He made me swear not to let anybody hospitalize him,” she says. “He made me swear not to let his family swoop in and take him away.”\u003c/p>\n\u003cp>At one point, John threatened to shoot himself to avoid that. Laura says a nurse dropped hints that there was a different way.\u003c/p>\n\u003cp>“I remember being told, here’s how much pain meds you can give,\" she says, \"but beyond this, he’ll probably stop breathing.\"\u003c/p>\n\u003cp>John made it clear to Laura that this was the way he wanted to go. Several times, she says, he reviewed the instructions with her.\u003c/p>\n\u003cp>Months later, John slipped into a coma. When the nurse said he looked like he was a day, maybe hours, away from dying, Laura took it as another hint.\u003c/p>\n\u003cp>“And I remember standing there with syringes in my hand. Just standing there, with my hands shaking,\" she says. She remembers thinking, \"Okay, what goes with what, goes with what?” Laura’s voice falters. “And I was all alone. And that was about the most alone I’ve ever felt. That I couldn’t tell anybody else.”\u003c/p>\n\u003cp>She injected the drugs. Then she crawled into bed with John and held him and talked to him for the next six hours.\u003c/p>\n\u003cp>“And he literally died in my arms. I was holding him when he stopped breathing,” Laura says. “And it was really peaceful. He just sort of drifted away.”\u003c/p>\n\u003cp>For years after John was gone, Laura had nightmares. Nightmares of staring at those syringes in her hand.\u003c/p>\n\u003cp>Today, she is confident that she did the right thing. John’s death was calm and peaceful and exactly what he’d asked for. But Laura resents that she was the one who had to do it, that she had no help, no real guidance from a medical professional.\u003c/p>\n\u003cp>“I don’t regret it, but I wouldn’t wish it on anybody else. It’s not fair. It’s not right,” she says. “It’s not like choosing to die doesn’t happen. We just make it be sneaky and we put it on the wrong people.”\u003c/p>\n\u003cp>Medical experts say stories like these are symptoms of a far bigger problem. Stanford medical ethicist David Magnus says doctors are just plain bad at communicating about death.\u003c/p>\n\u003cp>“What we really need is a much better, comprehensive discussion with patients about what they really want and what they care about and what they value,” Magnus says, “and that’s exactly what you tend not to get in medical settings.”\u003c/p>\n\u003cp>This leads to confusion. Magnus suggests that what some people interpret as hints on how to hasten someone’s death, actually aren't.\u003c/p>\n\u003cp>“Across the board with end-of-life care clinical interactions, they’re full of misunderstandings and misinterpretations,” he says.\u003c/p>\n\u003cp>On the flip side, Magnus says what some people believe is assisted suicide, actually isn’t. It is legal for people to take or give large doses of narcotics to relieve pain, even if a known side-effect is that it may hasten death.\u003c/p>\n\u003cp>“The difference really has to do with intent,” he says. “And that’s a tricky thing because it has to do with what’s going on in the mind.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>It’s such a fine line. When doctors are already so bad at understanding what dying patients and their families want, how good can they be at deciphering why?\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_25019\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/2.5.2011.2-e1429662884614.jpg\">\u003cimg class=\"size-large wp-image-25019\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/2.5.2011.2-640x480.jpg\" alt=\"When J.D. Arnold was dying of stomach cancer in 2011, his wife says doctors would only talk about death in euphemisms. (Photo: Hope Arnold)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">When J.D. Falk was dying of stomach cancer in 2011, his wife says doctors would only talk about death in euphemisms. (Photo: Hope Arnold)\u003c/figcaption>\u003c/figure>\n\u003cp>Physician-assisted suicide is illegal in California. But that doesn’t mean it doesn’t happen. Sick patients sometimes ask for help in hastening their deaths, and some doctors will explain, vaguely, how to do it.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“I remember standing there with syringes in my hand. Just standing there, with my hands shaking, and I was all alone.\" \u003c/aside>\n\u003cp>This leads to bizarre, veiled conversations between medical professionals who want to help, but also want to avoid prosecution, and overwhelmed family members who are left to interpret euphemisms at one of the most confusing times of their lives.\u003c/p>\n\u003cp>That’s what still frustrates Hope Arnold. She says throughout the 10 months her husband J.D. Falk was being treated for stomach cancer in 2011, no one would talk straight with them.\u003c/p>\n\u003cp>“All the nurses, all the doctors,\" says Hope, \"everybody we ever interacted with, no one said, ‘You’re dying.’ ”\u003c!--more-->\u003c/p>\n\u003cp>Until finally, one doctor did. And that’s when J.D. started to plan. He summoned his extended family. And Hope made arrangements for him to come home on hospice.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The day he was discharged from the hospital, Hope was dropping off some paperwork when she bumped into one of J.D.’s doctors.\u003c/p>\n\u003cp>“He hugged me and asked me how I was holding up,” she says. “And then he handed me a bottle of liquid morphine. He said, ‘You might need it.’ ”\u003c/p>\n\u003cp>Hope says she handed the bottle back. She told the doctor the hospice was going to drop off a machine that would administer J.D.’s pain medication automatically.\u003c/p>\n\u003cp>“And he looked at me,\" she says, \"and he held my gaze for a second. And he put it back in my hand and he said, ‘You Might. Need it.’”\u003c/p>\n\u003cp>She slipped the vial into her purse.\u003c/p>\n\u003cp>“When I got home, it hit me like a ton of bricks,” Hope remembers. “And I said to J.D., 'I think he may have given this to me so I can give you an overdose.' And he said, 'Maybe.' And then we didn’t talk about it anymore.”\u003c/p>\n\u003cp>Over the next couple days, J.D. deteriorated quickly. Hope says the hospice nurse offered another euphemism.\u003c/p>\n\u003cp>“He said, ‘He’s showing signs of imminence.’ ”\u003c/p>\n\u003cfigure id=\"attachment_25036\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/9.12.2009-1a.jpg\">\u003cimg class=\"size-medium wp-image-25036\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/9.12.2009-1a-300x288.jpg\" alt=\"Hope and J.D. Falk, on their wedding day. (Photo: Hope Arnold)\" width=\"300\" height=\"288\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Hope and J.D. Falk, on their wedding day. (Photo: Kelly Dunsford)\u003c/figcaption>\u003c/figure>\n\u003cp>Hope worried that J.D. was in a lot of pain. But she couldn’t tell. She was afraid that if she asked, it would betray the thoughts she was having about that extra vial of morphine.\u003c/p>\n\u003cp>“I couldn’t ask the nurse that,” Hope says. “I couldn’t ask anybody anything.”\u003c/p>\n\u003cp>In the end, she didn’t do it.\u003c/p>\n\u003cp>“J.D. never told me, 'I do want you to give me too much morphine,' \" Hope says. \"Actually, I don’t know whether or not he wanted that. That’s not the point. The point was nobody could talk about it.”\u003c/p>\n\u003cp>People don’t talk about it, but it’s happening. Just over 3 percent of U.S. doctors say they have written a prescription for life-ending medication, according to an \u003ca title=\"http://www.nejm.org/doi/full/10.1056/NEJM199804233381706#t=articleResults\" href=\"http://www.nejm.org/doi/full/10.1056/NEJM199804233381706#t=articleResults\" target=\"_blank\">anonymous survey\u003c/a> published in the New England Journal of Medicine. Almost 5 percent of doctors reported giving a patient a lethal injection.\u003c/p>\n\u003cp>\u003ca title=\"http://archinte.jamanetwork.com/article.aspx?articleid=214736#ira10015t4\" href=\"http://archinte.jamanetwork.com/article.aspx?articleid=214736#ira10015t4\" target=\"_blank\">Other studies\u003c/a> suggest oncologists, and doctors on the West Coast, are more likely to be asked for life-ending medication, or euthanasia, in which the doctor administers the lethal dose.\u003c/p>\n\u003cp>“Those practices are undercover, they are covert,” says Barbara Coombs Lee, president of Compassion and Choices, an advocacy group that is backing legislation in California to make it legal for doctors to prescribe lethal medication to terminally-ill patients who request it.\u003c/p>\n\u003cp>“To the degree that patients are part of the decision-making,\" Coombs Lee says, \"it is by winks and nods.”\u003c/p>\n\u003cp>Her organization actually guides dying patients how to get around current law.\u003c/p>\n\u003cp>“We talk with people about how they might broach the subject with their physicians,\" she says, \"and quite frankly, how to play the wink-and-nod game in a way that doesn’t jeopardize their physician.”\u003c/p>\n\u003cp>It’s a game Laura Bennett is all too familiar with. (Laura’s name has been changed to protect her privacy.) Laura lived in San Francisco during the 1980s and watched one friend after another die of AIDS.\u003c/p>\n\u003cp>“The guys would have fungus everywhere,\" she recounts. \"Horrible diarrheas, emaciation. “It looked like concentration camp pictures.”\u003c/p>\n\u003cp>A lot of the guys begged for lethal drugs to end their suffering. Laura and her friends figured out which doctors were willing to help.\u003c/p>\n\u003cp>“We would tell each other, ‘This is the doctor,'\" she says. \"'They’re going to tell you how much is too much to give, and then they’re going to give you too much.'\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/202083156&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/202083156'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Though Laura witnessed many deaths hastened in this way, she says she never injected the drugs herself. Her time would come 20 years later when her husband John was dying of throat cancer. (John’s name has also been changed).\u003c/p>\n\u003cp>Some of his symptoms were brutal.\u003c/p>\n\u003cp>“It was like a horror movie,” Laura says, recalling the tumors all over John’s neck. They would fill with blood, she says, and sometimes burst.\u003c/p>\n\u003cp>“There’d be blood on the walls, on the mirror, everywhere,\" Laura recounts, \"and I’d be trying to keep him from drowning in it because it’d be going down his trach. And he’d be panicking.”\u003c/p>\n\u003cp>John was warned his death might be ugly. He might choke. He might have a seizure. More than anything, Laura says, John was afraid of dying in a hospital, hooked up to machines, powerless.\u003c/p>\n\u003cp>“He made me swear not to let anybody hospitalize him,” she says. “He made me swear not to let his family swoop in and take him away.”\u003c/p>\n\u003cp>At one point, John threatened to shoot himself to avoid that. Laura says a nurse dropped hints that there was a different way.\u003c/p>\n\u003cp>“I remember being told, here’s how much pain meds you can give,\" she says, \"but beyond this, he’ll probably stop breathing.\"\u003c/p>\n\u003cp>John made it clear to Laura that this was the way he wanted to go. Several times, she says, he reviewed the instructions with her.\u003c/p>\n\u003cp>Months later, John slipped into a coma. When the nurse said he looked like he was a day, maybe hours, away from dying, Laura took it as another hint.\u003c/p>\n\u003cp>“And I remember standing there with syringes in my hand. Just standing there, with my hands shaking,\" she says. She remembers thinking, \"Okay, what goes with what, goes with what?” Laura’s voice falters. “And I was all alone. And that was about the most alone I’ve ever felt. That I couldn’t tell anybody else.”\u003c/p>\n\u003cp>She injected the drugs. Then she crawled into bed with John and held him and talked to him for the next six hours.\u003c/p>\n\u003cp>“And he literally died in my arms. I was holding him when he stopped breathing,” Laura says. “And it was really peaceful. He just sort of drifted away.”\u003c/p>\n\u003cp>For years after John was gone, Laura had nightmares. Nightmares of staring at those syringes in her hand.\u003c/p>\n\u003cp>Today, she is confident that she did the right thing. John’s death was calm and peaceful and exactly what he’d asked for. But Laura resents that she was the one who had to do it, that she had no help, no real guidance from a medical professional.\u003c/p>\n\u003cp>“I don’t regret it, but I wouldn’t wish it on anybody else. It’s not fair. It’s not right,” she says. “It’s not like choosing to die doesn’t happen. We just make it be sneaky and we put it on the wrong people.”\u003c/p>\n\u003cp>Medical experts say stories like these are symptoms of a far bigger problem. Stanford medical ethicist David Magnus says doctors are just plain bad at communicating about death.\u003c/p>\n\u003cp>“What we really need is a much better, comprehensive discussion with patients about what they really want and what they care about and what they value,” Magnus says, “and that’s exactly what you tend not to get in medical settings.”\u003c/p>\n\u003cp>This leads to confusion. Magnus suggests that what some people interpret as hints on how to hasten someone’s death, actually aren't.\u003c/p>\n\u003cp>“Across the board with end-of-life care clinical interactions, they’re full of misunderstandings and misinterpretations,” he says.\u003c/p>\n\u003cp>On the flip side, Magnus says what some people believe is assisted suicide, actually isn’t. It is legal for people to take or give large doses of narcotics to relieve pain, even if a known side-effect is that it may hasten death.\u003c/p>\n\u003cp>“The difference really has to do with intent,” he says. “And that’s a tricky thing because it has to do with what’s going on in the mind.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It’s such a fine line. When doctors are already so bad at understanding what dying patients and their families want, how good can they be at deciphering why?\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Panel Votes To End Vaccine Exemption in California",
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"content": "\u003cp>\u003cstrong>By David Gorn, \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2015/4/panel-votes-to-end-vaccine-exemption\" target=\"_blank\">California Healthline\u003c/a>\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_24920\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/vaccination.jpg\">\u003cimg class=\"size-large wp-image-24920\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/vaccination-640x424.jpg\" alt=\"Lawmakers took step toward passage of a bill that would end the personal-belief exemption for childhood immunizations in California. (Centers for Disease Control and Prevention's Public Health Image Library)\" width=\"640\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lawmakers took step toward passage of a bill that would end the personal-belief exemption for childhood immunizations in California. (Centers for Disease Control and Prevention's Public Health Image Library) \u003ccite>(Centers for Disease Control and Prevention's Public Health Image Library)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>On Wednesday, lawmakers took the first step toward passage of a bill that would end the personal-belief exemption for childhood immunizations in California.\u003c/p>\n\u003cp>The Senate Committee on Health on Wednesday voted to approve SB 277 by state Sen. Richard Pan (D-Sacramento). It would stop California parents from opting out of immunizations for their schoolchildren unless there is a medical reason to refuse vaccination.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"There is no scientific controversy about vaccine safety and vaccine effectiveness. This is not open to dispute among mainstream doctors and scientists.\"\u003c/aside>\n\u003cp>Pan, a pediatrician, said the recent outbreaks of measles and whooping cough could be prevented if a higher percentage of children were immunized against the diseases.\u003c/p>\n\u003cp>\"I've personally witnessed the suffering caused by vaccine-preventable diseases,\" Pan said. \"All children deserve to be safe at school. The personal belief exemption is now putting other schoolchildren and people in our community in danger.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Wednesday's hearing was at times unruly and emotional, as anti-vaccine advocates sometimes made their cases loudly and with venom. One woman was removed from the hearing room after a loud and emotional outburst, and another person threatened to put a curse on lawmakers who voted for the bill.\u003c/p>\n\u003cp>\"There's no place for this [in a committee hearing],\" said committee member state Sen. Bill Monning (D-Carmel). \"I don't want to take away from the people who made their points respectfully, but there is no place for this.\"\u003c/p>\n\u003cp>The legislation was prompted, in part, by a measles outbreak that originated in California and spread to half a dozen other states, infecting 147 children. Last year, California had the largest outbreak of whooping cough in the past 70 years, with one infant death and more than 10,000 cases reported statewide.\u003c/p>\n\u003cp>\"Let me be clear,\" said Dean Blumberg, a Sacramento pediatrician representing the American Academy of Pediatrics and the California Medical Association. \"There is no scientific controversy about vaccine safety and vaccine effectiveness. This is not open to dispute among mainstream doctors and scientists.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The billed passed on a 6-2 vote.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By David Gorn, \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2015/4/panel-votes-to-end-vaccine-exemption\" target=\"_blank\">California Healthline\u003c/a>\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_24920\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/vaccination.jpg\">\u003cimg class=\"size-large wp-image-24920\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/vaccination-640x424.jpg\" alt=\"Lawmakers took step toward passage of a bill that would end the personal-belief exemption for childhood immunizations in California. (Centers for Disease Control and Prevention's Public Health Image Library)\" width=\"640\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lawmakers took step toward passage of a bill that would end the personal-belief exemption for childhood immunizations in California. (Centers for Disease Control and Prevention's Public Health Image Library) \u003ccite>(Centers for Disease Control and Prevention's Public Health Image Library)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>On Wednesday, lawmakers took the first step toward passage of a bill that would end the personal-belief exemption for childhood immunizations in California.\u003c/p>\n\u003cp>The Senate Committee on Health on Wednesday voted to approve SB 277 by state Sen. Richard Pan (D-Sacramento). It would stop California parents from opting out of immunizations for their schoolchildren unless there is a medical reason to refuse vaccination.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"There is no scientific controversy about vaccine safety and vaccine effectiveness. This is not open to dispute among mainstream doctors and scientists.\"\u003c/aside>\n\u003cp>Pan, a pediatrician, said the recent outbreaks of measles and whooping cough could be prevented if a higher percentage of children were immunized against the diseases.\u003c/p>\n\u003cp>\"I've personally witnessed the suffering caused by vaccine-preventable diseases,\" Pan said. \"All children deserve to be safe at school. The personal belief exemption is now putting other schoolchildren and people in our community in danger.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Wednesday's hearing was at times unruly and emotional, as anti-vaccine advocates sometimes made their cases loudly and with venom. One woman was removed from the hearing room after a loud and emotional outburst, and another person threatened to put a curse on lawmakers who voted for the bill.\u003c/p>\n\u003cp>\"There's no place for this [in a committee hearing],\" said committee member state Sen. Bill Monning (D-Carmel). \"I don't want to take away from the people who made their points respectfully, but there is no place for this.\"\u003c/p>\n\u003cp>The legislation was prompted, in part, by a measles outbreak that originated in California and spread to half a dozen other states, infecting 147 children. Last year, California had the largest outbreak of whooping cough in the past 70 years, with one infant death and more than 10,000 cases reported statewide.\u003c/p>\n\u003cp>\"Let me be clear,\" said Dean Blumberg, a Sacramento pediatrician representing the American Academy of Pediatrics and the California Medical Association. \"There is no scientific controversy about vaccine safety and vaccine effectiveness. This is not open to dispute among mainstream doctors and scientists.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The billed passed on a 6-2 vote.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Uninsured? Here Are Alternative Options for Medical Care",
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"content": "\u003cp>\u003cstrong>By Emily Bazar, \u003ca href=\"http://centerforhealthreporting.org/\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_24898\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/medi-cal.jpg\">\u003cimg class=\"size-large wp-image-24898\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/medi-cal-640x427.jpg\" alt=\"Millions of still Californians remain uninsured, either by choice or immigration status. (Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Millions of still Californians remain uninsured, either by choice or immigration status. (Getty Images) \u003ccite>(Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>About 5 million Californians have new health coverage as a result of the Affordable Care Act (ACA), both through the Covered California health insurance exchange and the expansion of Medi-Cal, California’s Medicaid program for low-income residents.\u003c/p>\n\u003cp>But millions of others remain uninsured – by circumstance or by choice.\u003c/p>\n\u003cp>Up to half of California’s uninsured population is made up of immigrants who are not in the country legally, and therefore are excluded from health insurance exchanges, tax credits and most Medi-Cal coverage. Others can’t afford coverage (even if it’s subsidized), choose not to buy insurance, or are unaware that they qualify for free or subsidized insurance.\u003c/p>\n\u003cp>No matter who they are or what their circumstances, they get sick, too.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Q: I’m uninsured but need medical care. What are my options?\u003c/strong>\u003c/p>\n\u003cp>A: It’s hard to pin down exactly how many Californians remain uninsured, but Anthony Wright, executive director of Health Access California, believes there are roughly 3 million of you.\u003c/p>\n\u003cp>The good news is that more than a third of you are actually eligible for coverage, either Medi-Cal or subsidized insurance through Covered California, says Laurel Lucia, an ACA expert at UC Berkeley’s Center for Labor Research and Education.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>So my first piece of advice is perhaps the most important: Find out if you’re eligible for some kind of coverage.\u003c/p>\n\u003cp>Covered California’s open enrollment season has ended for this year, but Medi-Cal enrollment stays open year-round, and Medi-Cal is free for most people who qualify.\u003c/p>\n\u003cp>If you have a specific disease, you may be able to get coverage from state programs such as California Children’s Services and the AIDS Drug Assistance Program, says Daniel Zingale, senior vice president of the California Endowment.\u003c/p>\n\u003cp>Also, San Francisco, Los Angeles and some other counties offer county-based health benefits for uninsured residents such as Healthy San Francisco and My Health LA, Wright says. Check to see what your county offers.\u003c/p>\n\u003cp>If you don’t qualify for anything, your health care options will depend largely on three things: Your location, your income and your immigration status.\u003c/p>\n\u003cp>“It really is a patchwork,” Wright says. “Depending on your county, you may have very different levels of access to care.”\u003c/p>\n\u003cp>\u003cstrong>County Health Systems\u003c/strong>\u003c/p>\n\u003cp>California’s counties run a mishmash of health programs. Some operate public hospitals, others contract with private providers and still others run clinics.\u003c/p>\n\u003cp>Your eligibility also varies widely by county, whether we’re talking income or immigration status.\u003c/p>\n\u003cp>“If you’re undocumented in LA County, the county clinics are where you’d go,” Zingale says. That is not the case in 48 of the state’s 58 counties, he says.\u003c/p>\n\u003cp>Check with your county to explore your options.\u003c/p>\n\u003cp>\u003cstrong>Community Clinics\u003c/strong>\u003c/p>\n\u003cp>Separate from county clinics, California’s roughly 1,100 community health clinics serve about 5.6 million people each year, says Carmela Castellano-Garcia, president and CEO of the California Primary Care Association.\u003c/p>\n\u003cp>Of those, about 2 million are uninsured, she says.\u003c/p>\n\u003cp>There are different types of clinics, but in general clinics provide primary and preventive care regardless of immigration status, and their prices are set on a sliding-fee scale based on income, Castellano-Garcia says.\u003c/p>\n\u003cp>Free clinics charge nothing at all.\u003c/p>\n\u003cp>“How much you pay depends on the kind of clinic you go to,” she says.\u003c/p>\n\u003cp>Want to find a clinic near you? Castellano-Garcia suggests visiting www.CaliforniaHealthPlus.com and using its online clinic locator tool.\u003c/p>\n\u003cp>\u003cstrong>Emergency Room/Hospital Care\u003c/strong>\u003c/p>\n\u003cp>Federal law requires emergency rooms to stabilize patients without asking about their immigration status or ability to pay.\u003c/p>\n\u003cp>But if you’re uninsured, you’ll be responsible for the bills, which can easily climb into the tens of thousands of dollars and wreck your credit.\u003c/p>\n\u003cp>Want proof? A December report from the Consumer Financial Protection Bureau found that medical collections comprise more than half of collection accounts on credit reports.\u003c/p>\n\u003cp>But there are some options. Though unauthorized immigrants are not eligible for full Medi-Cal benefits, they may be eligible for emergency care and pregnancy-related services, based on income.\u003c/p>\n\u003cp>Also, most hospitals offer financial assistance and “charity care” to patients, also based on income, Wright says.\u003c/p>\n\u003cp>The ACA offers new protections to consumers who use nonprofit hospitals, such as limiting how much consumers at certain incomes can be billed.\u003c/p>\n\u003cp>But California has stronger protections, Wright says. A pre-existing state law requires all hospitals to inform consumers about their rights and financial options, give them 150 days before their bills get sent to collections and limit the amount that uninsured consumers at certain incomes must pay, he says.\u003c/p>\n\u003cp>Health Access and other groups host a website – www.HospitalBillHelp.org – that will help you find discounted or charity care in your area. You can also visit a state-run website to search for similar information: https://syfphr.oshpd.ca.gov/\u003c/p>\n\u003cp>Consumer groups also support legislation that would address health coverage for the uninsured. For instance, a proposed law (SB 4) would make unauthorized immigrants eligible for Medi-Cal, assuming they meet the program’s criteria, and allow them to buy unsubsidized plans from Covered California with their own money. A similar measure stalled last year.\u003c/p>\n\u003cp>\u003cem>Questions for Emily: AskEmily@usc.edu\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The CHCF Center for Health Reporting partners with news organizations to cover California health policy. Located at the USC Annenberg School for Communication and Journalism, it is funded by the nonpartisan California HealthCare Foundation.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Emily Bazar, \u003ca href=\"http://centerforhealthreporting.org/\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_24898\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/medi-cal.jpg\">\u003cimg class=\"size-large wp-image-24898\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/medi-cal-640x427.jpg\" alt=\"Millions of still Californians remain uninsured, either by choice or immigration status. (Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Millions of still Californians remain uninsured, either by choice or immigration status. (Getty Images) \u003ccite>(Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>About 5 million Californians have new health coverage as a result of the Affordable Care Act (ACA), both through the Covered California health insurance exchange and the expansion of Medi-Cal, California’s Medicaid program for low-income residents.\u003c/p>\n\u003cp>But millions of others remain uninsured – by circumstance or by choice.\u003c/p>\n\u003cp>Up to half of California’s uninsured population is made up of immigrants who are not in the country legally, and therefore are excluded from health insurance exchanges, tax credits and most Medi-Cal coverage. Others can’t afford coverage (even if it’s subsidized), choose not to buy insurance, or are unaware that they qualify for free or subsidized insurance.\u003c/p>\n\u003cp>No matter who they are or what their circumstances, they get sick, too.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Q: I’m uninsured but need medical care. What are my options?\u003c/strong>\u003c/p>\n\u003cp>A: It’s hard to pin down exactly how many Californians remain uninsured, but Anthony Wright, executive director of Health Access California, believes there are roughly 3 million of you.\u003c/p>\n\u003cp>The good news is that more than a third of you are actually eligible for coverage, either Medi-Cal or subsidized insurance through Covered California, says Laurel Lucia, an ACA expert at UC Berkeley’s Center for Labor Research and Education.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>So my first piece of advice is perhaps the most important: Find out if you’re eligible for some kind of coverage.\u003c/p>\n\u003cp>Covered California’s open enrollment season has ended for this year, but Medi-Cal enrollment stays open year-round, and Medi-Cal is free for most people who qualify.\u003c/p>\n\u003cp>If you have a specific disease, you may be able to get coverage from state programs such as California Children’s Services and the AIDS Drug Assistance Program, says Daniel Zingale, senior vice president of the California Endowment.\u003c/p>\n\u003cp>Also, San Francisco, Los Angeles and some other counties offer county-based health benefits for uninsured residents such as Healthy San Francisco and My Health LA, Wright says. Check to see what your county offers.\u003c/p>\n\u003cp>If you don’t qualify for anything, your health care options will depend largely on three things: Your location, your income and your immigration status.\u003c/p>\n\u003cp>“It really is a patchwork,” Wright says. “Depending on your county, you may have very different levels of access to care.”\u003c/p>\n\u003cp>\u003cstrong>County Health Systems\u003c/strong>\u003c/p>\n\u003cp>California’s counties run a mishmash of health programs. Some operate public hospitals, others contract with private providers and still others run clinics.\u003c/p>\n\u003cp>Your eligibility also varies widely by county, whether we’re talking income or immigration status.\u003c/p>\n\u003cp>“If you’re undocumented in LA County, the county clinics are where you’d go,” Zingale says. That is not the case in 48 of the state’s 58 counties, he says.\u003c/p>\n\u003cp>Check with your county to explore your options.\u003c/p>\n\u003cp>\u003cstrong>Community Clinics\u003c/strong>\u003c/p>\n\u003cp>Separate from county clinics, California’s roughly 1,100 community health clinics serve about 5.6 million people each year, says Carmela Castellano-Garcia, president and CEO of the California Primary Care Association.\u003c/p>\n\u003cp>Of those, about 2 million are uninsured, she says.\u003c/p>\n\u003cp>There are different types of clinics, but in general clinics provide primary and preventive care regardless of immigration status, and their prices are set on a sliding-fee scale based on income, Castellano-Garcia says.\u003c/p>\n\u003cp>Free clinics charge nothing at all.\u003c/p>\n\u003cp>“How much you pay depends on the kind of clinic you go to,” she says.\u003c/p>\n\u003cp>Want to find a clinic near you? Castellano-Garcia suggests visiting www.CaliforniaHealthPlus.com and using its online clinic locator tool.\u003c/p>\n\u003cp>\u003cstrong>Emergency Room/Hospital Care\u003c/strong>\u003c/p>\n\u003cp>Federal law requires emergency rooms to stabilize patients without asking about their immigration status or ability to pay.\u003c/p>\n\u003cp>But if you’re uninsured, you’ll be responsible for the bills, which can easily climb into the tens of thousands of dollars and wreck your credit.\u003c/p>\n\u003cp>Want proof? A December report from the Consumer Financial Protection Bureau found that medical collections comprise more than half of collection accounts on credit reports.\u003c/p>\n\u003cp>But there are some options. Though unauthorized immigrants are not eligible for full Medi-Cal benefits, they may be eligible for emergency care and pregnancy-related services, based on income.\u003c/p>\n\u003cp>Also, most hospitals offer financial assistance and “charity care” to patients, also based on income, Wright says.\u003c/p>\n\u003cp>The ACA offers new protections to consumers who use nonprofit hospitals, such as limiting how much consumers at certain incomes can be billed.\u003c/p>\n\u003cp>But California has stronger protections, Wright says. A pre-existing state law requires all hospitals to inform consumers about their rights and financial options, give them 150 days before their bills get sent to collections and limit the amount that uninsured consumers at certain incomes must pay, he says.\u003c/p>\n\u003cp>Health Access and other groups host a website – www.HospitalBillHelp.org – that will help you find discounted or charity care in your area. You can also visit a state-run website to search for similar information: https://syfphr.oshpd.ca.gov/\u003c/p>\n\u003cp>Consumer groups also support legislation that would address health coverage for the uninsured. For instance, a proposed law (SB 4) would make unauthorized immigrants eligible for Medi-Cal, assuming they meet the program’s criteria, and allow them to buy unsubsidized plans from Covered California with their own money. A similar measure stalled last year.\u003c/p>\n\u003cp>\u003cem>Questions for Emily: AskEmily@usc.edu\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The CHCF Center for Health Reporting partners with news organizations to cover California health policy. Located at the USC Annenberg School for Communication and Journalism, it is funded by the nonpartisan California HealthCare Foundation.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Doctors with Cancer Join California Movement for 'Aid in Dying'",
"title": "Doctors with Cancer Join California Movement for 'Aid in Dying'",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_24761\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/DSCN0305-e1427734238891.jpg\">\u003cimg class=\"size-large wp-image-24761\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/DSCN0305-640x480.jpg\" alt=\"Dan Swangard, a 48-year-old physician from San Francisco, was diagnosed in 2013 with a rare form of metastatic cancer. (Anna Gorman/KHN)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dan Swangard, a 48-year-old physician from San Francisco, was diagnosed in 2013 with a rare form of metastatic cancer. (Anna Gorman/KHN)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Anna Gorman,\u003c/strong> \u003ca title=\"http://kaiserhealthnews.org/news/hoping-to-live-these-doctors-want-a-choice-in-how-they-die/\" href=\"http://kaiserhealthnews.org/news/hoping-to-live-these-doctors-want-a-choice-in-how-they-die/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Dan Swangard knows what death looks like.\u003c/p>\n\u003cp>As a physician, he has seen patients die in hospitals, hooked to morphine drips and overcome with anxiety. He has watched dying drag on for weeks or months as terrified relatives stand by helplessly.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“It’s very real for me. This could be my own issue a year from now.”\u003c/aside>\n\u003cp>Recently, however, his thoughts about how seriously ill people die have become personal. Swangard was diagnosed in 2013 with a rare form of metastatic cancer.\u003c/p>\n\u003cp>To remove the cancer, surgeons took out parts of his pancreas and liver, as well as his entire spleen and gallbladder. The operation was successful but Swangard, 48, knows there’s a strong chance the disease will return. And if he gets to a point where there’s nothing more medicine can do, he wants to be able to control when and how his life ends.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s very real for me,” said Swangard, who lives in Bolinas, Calif. “This could be my own issue a year from now.”\u003c!--more-->\u003c/p>\n\u003cp>That’s one of the reasons Swangard joined a California lawsuit last month seeking to let doctors prescribe lethal medications to certain patients who want to hasten death. If he were given only months to live, Swangard said, he can’t say for certain whether he would take them.\u003c/p>\n\u003cp>“But I want to be able to make that choice,” he said.\u003c/p>\n\u003cp>The right-to-die movement has gained renewed momentum in California and around the nation following the highly publicized death of an East Bay woman with brain cancer. Brittany Maynard, 29, moved to Oregon to take advantage of its “Death with Dignity” law and died in November after taking a fatal dose of barbiturates prescribed by her doctor.\u003c/p>\n\u003cp>The California lawsuit asks the court to protect physicians from liability if they prescribe lethal medications to patients who are both terminally ill and mentally competent to decide their fate.\u003c/p>\n\u003cp>[contextly_sidebar id=\"haIJdBeaTK2L2aNSQP1MdhGr9HxMuMq1\"]\u003c/p>\n\u003cp>The lawsuit argues that while it is against the law in California for anyone to assist in another’s suicide, these cases are not suicides. Rather, the suit argues, they are choices by a dying person on how his or her life should end and decisions about one’s own body protected under the state constitution.\u003c/p>\n\u003cp>Separately, two California state senators have proposed a bill that would allow doctors to prescribe lethal medication to certain terminally ill adults.\u003c/p>\n\u003cp>Three states — Oregon, Washington and Vermont — already have laws allowing physician-assisted deaths. Courts in New Mexico and Montana also have ruled that aid in dying is legal, and a suit was also recently filed in New York.\u003c/p>\n\u003cp>Legislation is pending in several other states. Kathryn Tucker, an attorney on several of the court cases, is also spearheading the California lawsuit. This time, she and her legal team decided to include among the plaintiffs two doctors with life-threatening illnesses, Swangard and a retired San Francisco obstetrician.\u003c/p>\n\u003cp>Physicians “have a very deep and broad understanding about what the journey to death can be like,” said Tucker, executive director of the Disability Rights Legal Center. “The curtain is pulled back. For lay people, death is much more mysterious.”\u003c/p>\n\u003cp>But a recent survey of 21,000 doctors in the U.S. and Europe shows views may be shifting. According to Medscape, the organization that did the survey, 54 percent of American doctors support assisted suicide, up from 46 percent four years earlier. Historically, doctors have been some of the most vocal critics of assisted suicide, also called aid-in-dying. The American Medical Association still says that “physician-assisted suicide is fundamentally incompatible with the physician’s role as healer.” Similarly, the California Medical Association takes the view that helping patients die conflicts with doctors’ commitment to do no harm. “It is the physicians’ job to take care of the patient and that is amplified when that patient is most sick,” said spokeswoman Molly Weedn.\u003c/p>\n\u003cp>Swangard is among those who believe that taking care of patients means letting them choose how their lives should end. That’s not the same as killing patients or facilitating suicide, he said.\u003c/p>\n\u003cp>Swangard completed his medical residency in San Francisco in the middle of the AIDS crisis; young men were dying all around him. Throughout his career as an internal medicine doctor, a hospice volunteer and now an anesthesiologist, he has become frustrated with how the medical system handles death. Doctors spend so much time trying to extend life that few focus on what patients want in their last days, he said.\u003c/p>\n\u003cp>“I don’t think we know how to die,” he said. “We fight tooth and nail to keep that from happening.”\u003c/p>\n\u003cp>[contextly_sidebar id=\"ILqrwTkVsGGtAYwEnHms9CvV1Pn6Ubfl\"]\u003c/p>\n\u003cp>Swangard’s own illness was discovered in early 2013 during a long-overdue checkup. He hadn’t been worried about his health — he was obsessed with fitness, swimming regularly and seeing a trainer twice a week. But when the doctor pressed on Swangard’s stomach, he felt a mango-sized mass.\u003c/p>\n\u003cp>He had a visceral feeling, he said, “something bad was happening.”\u003c/p>\n\u003cp>Within a week, a surgeon found a neuroendocrine tumor in the pancreas and metastasis in the liver. It was the same cancer that took Steve Jobs’ life — one that doesn’t generally respond to chemotherapy or radiation. “My fears became real,” he said.\u003c/p>\n\u003cp>The doctors told him they believed they got all the cancerous cells. But Swangard was tormented by questions: Am I going to be alive in a year? Is my cancer going to come back?\u003c/p>\n\u003cp>“I wasn’t sleeping, I wasn’t exercising, I was marinating in my own sadness and fear of what this all meant,” he said. “I thought, ‘This is going to kill me.’”\u003c/p>\n\u003cp>Since his diagnosis, Swangard said he has had a greater understanding of his patients’ struggles. Occasionally, he holds their hands and tells them he has been where they are.\u003c/p>\n\u003cp>Earlier this year, a physician friend asked him if he’d be willing to join the California case. Swangard didn’t hesitate. He didn’t go into medicine to help dying people linger and wants to help change that approach — for his patients and for himself.\u003c/p>\n\u003cp>When he dies, Swangard said, he wants to be surrounded by people he loves. He doesn’t want to be in a drug-induced haze, nor consumed by worry about what’s next. He wants to be able to say goodbye.\u003c/p>\n\u003cp>“It is a little bit of a blessing to know how I might die,” he said. “I don’t think a lot of patients have insight into what to expect.”\u003c/p>\n\u003cp>These days, he wears a Buddhist prayer bracelet, a reminder to focus on the present. He cut his work hours, swims as often as he can and meditates regularly. At home, he stares out at the ocean, often watching dolphins pass by. He makes every effort to stay calm and healthy.\u003c/p>\n\u003cp>He is in remission but he knows that what happens with the cancer is largely outside his control. An MRI last year showed a small lesion in his liver, which doctors are watching closely.\u003c/p>\n\u003cp>“It’s this big unknown,” he said.\u003c/p>\n\u003cfigure id=\"attachment_24772\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/DSCN0347-e1427736893164.jpg\">\u003cimg class=\"size-medium wp-image-24772\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/DSCN0347-300x225.jpg\" alt=\"Retired San Francisco obstetrician Robert Liner, 70, is a plaintiff in a California lawsuit seeking to let doctors prescribe lethal medications to certain patients who want to die. (Anna Gorman/KHN)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Retired San Francisco obstetrician Robert Liner, 70, is a plaintiff in a California lawsuit seeking to let doctors prescribe lethal medications to certain patients who want to die. (Anna Gorman/KHN)\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. Robert Liner, a fellow plaintiff who only recently met Swangard, lives with the same uncertainty.\u003c/p>\n\u003cp>On his 69th birthday in May 2013, the retired obstetrician had a bad cough. He felt tired and short of breath. His wife took him to the hospital, where doctors discovered malignant masses on his kidneys — advanced-stage lymphoma.\u003c/p>\n\u003cp>After radiation and chemotherapy, the tumors shrank. He also is in remission. But if the cancer comes back, he said, “the prospects are not going to be good.”\u003c/p>\n\u003cp>He often thinks of a former patient, a 25-year-old woman with metastatic ovarian cancer. She wanted to die while she still was able to communicate. Liner wasn’t able to help ease her death because the law wouldn’t let him. “I felt like I’d failed her,” he said.\u003c/p>\n\u003cp>Years before his diagnosis, Liner, now 70, became involved with Compassion & Choices, an organization that promotes aid-in-dying. He has a shelf of books in his San Francisco home devoted to the subject: Being Mortal, Dying Right, Knocking on Heaven’s Door.\u003c/p>\n\u003cp>He keeps a stack of notecards with quotes about the end of life, which he often recites in speeches to church groups or senior centers. One reads, “The best preparation for death is a life well-lived.”\u003c/p>\n\u003cp>He believes having medication to hasten death helps terminally ill people live fully in their last weeks or months without being immobilized by fear. “If you are riddled with anxiety, you are not free to concentrate on what’s most meaningful to you,” he said.\u003c/p>\n\u003cp>Like Swangard, Liner doesn’t know if he would take the medication. He recently married the woman he calls his “beloved” and said he has lots of plans for his retirement years, including writing a screenplay and improving his piano playing.\u003c/p>\n\u003cp>“My wife says I’d be hanging on to life by my fingernails,” he said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>But that decision should be his to make, with his family and his doctor, he said. “I want the comfort of knowing it’s up to me when enough is enough,” he said.\u003c/p>\n\n",
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"excerpt": "Dr. Dan Swangard has metastatic cancer. He joined a lawsuit to change California law to allow physician-assisted suicide.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24761\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/DSCN0305-e1427734238891.jpg\">\u003cimg class=\"size-large wp-image-24761\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/DSCN0305-640x480.jpg\" alt=\"Dan Swangard, a 48-year-old physician from San Francisco, was diagnosed in 2013 with a rare form of metastatic cancer. (Anna Gorman/KHN)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dan Swangard, a 48-year-old physician from San Francisco, was diagnosed in 2013 with a rare form of metastatic cancer. (Anna Gorman/KHN)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Anna Gorman,\u003c/strong> \u003ca title=\"http://kaiserhealthnews.org/news/hoping-to-live-these-doctors-want-a-choice-in-how-they-die/\" href=\"http://kaiserhealthnews.org/news/hoping-to-live-these-doctors-want-a-choice-in-how-they-die/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Dan Swangard knows what death looks like.\u003c/p>\n\u003cp>As a physician, he has seen patients die in hospitals, hooked to morphine drips and overcome with anxiety. He has watched dying drag on for weeks or months as terrified relatives stand by helplessly.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“It’s very real for me. This could be my own issue a year from now.”\u003c/aside>\n\u003cp>Recently, however, his thoughts about how seriously ill people die have become personal. Swangard was diagnosed in 2013 with a rare form of metastatic cancer.\u003c/p>\n\u003cp>To remove the cancer, surgeons took out parts of his pancreas and liver, as well as his entire spleen and gallbladder. The operation was successful but Swangard, 48, knows there’s a strong chance the disease will return. And if he gets to a point where there’s nothing more medicine can do, he wants to be able to control when and how his life ends.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s very real for me,” said Swangard, who lives in Bolinas, Calif. “This could be my own issue a year from now.”\u003c!--more-->\u003c/p>\n\u003cp>That’s one of the reasons Swangard joined a California lawsuit last month seeking to let doctors prescribe lethal medications to certain patients who want to hasten death. If he were given only months to live, Swangard said, he can’t say for certain whether he would take them.\u003c/p>\n\u003cp>“But I want to be able to make that choice,” he said.\u003c/p>\n\u003cp>The right-to-die movement has gained renewed momentum in California and around the nation following the highly publicized death of an East Bay woman with brain cancer. Brittany Maynard, 29, moved to Oregon to take advantage of its “Death with Dignity” law and died in November after taking a fatal dose of barbiturates prescribed by her doctor.\u003c/p>\n\u003cp>The California lawsuit asks the court to protect physicians from liability if they prescribe lethal medications to patients who are both terminally ill and mentally competent to decide their fate.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The lawsuit argues that while it is against the law in California for anyone to assist in another’s suicide, these cases are not suicides. Rather, the suit argues, they are choices by a dying person on how his or her life should end and decisions about one’s own body protected under the state constitution.\u003c/p>\n\u003cp>Separately, two California state senators have proposed a bill that would allow doctors to prescribe lethal medication to certain terminally ill adults.\u003c/p>\n\u003cp>Three states — Oregon, Washington and Vermont — already have laws allowing physician-assisted deaths. Courts in New Mexico and Montana also have ruled that aid in dying is legal, and a suit was also recently filed in New York.\u003c/p>\n\u003cp>Legislation is pending in several other states. Kathryn Tucker, an attorney on several of the court cases, is also spearheading the California lawsuit. This time, she and her legal team decided to include among the plaintiffs two doctors with life-threatening illnesses, Swangard and a retired San Francisco obstetrician.\u003c/p>\n\u003cp>Physicians “have a very deep and broad understanding about what the journey to death can be like,” said Tucker, executive director of the Disability Rights Legal Center. “The curtain is pulled back. For lay people, death is much more mysterious.”\u003c/p>\n\u003cp>But a recent survey of 21,000 doctors in the U.S. and Europe shows views may be shifting. According to Medscape, the organization that did the survey, 54 percent of American doctors support assisted suicide, up from 46 percent four years earlier. Historically, doctors have been some of the most vocal critics of assisted suicide, also called aid-in-dying. The American Medical Association still says that “physician-assisted suicide is fundamentally incompatible with the physician’s role as healer.” Similarly, the California Medical Association takes the view that helping patients die conflicts with doctors’ commitment to do no harm. “It is the physicians’ job to take care of the patient and that is amplified when that patient is most sick,” said spokeswoman Molly Weedn.\u003c/p>\n\u003cp>Swangard is among those who believe that taking care of patients means letting them choose how their lives should end. That’s not the same as killing patients or facilitating suicide, he said.\u003c/p>\n\u003cp>Swangard completed his medical residency in San Francisco in the middle of the AIDS crisis; young men were dying all around him. Throughout his career as an internal medicine doctor, a hospice volunteer and now an anesthesiologist, he has become frustrated with how the medical system handles death. Doctors spend so much time trying to extend life that few focus on what patients want in their last days, he said.\u003c/p>\n\u003cp>“I don’t think we know how to die,” he said. “We fight tooth and nail to keep that from happening.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Swangard’s own illness was discovered in early 2013 during a long-overdue checkup. He hadn’t been worried about his health — he was obsessed with fitness, swimming regularly and seeing a trainer twice a week. But when the doctor pressed on Swangard’s stomach, he felt a mango-sized mass.\u003c/p>\n\u003cp>He had a visceral feeling, he said, “something bad was happening.”\u003c/p>\n\u003cp>Within a week, a surgeon found a neuroendocrine tumor in the pancreas and metastasis in the liver. It was the same cancer that took Steve Jobs’ life — one that doesn’t generally respond to chemotherapy or radiation. “My fears became real,” he said.\u003c/p>\n\u003cp>The doctors told him they believed they got all the cancerous cells. But Swangard was tormented by questions: Am I going to be alive in a year? Is my cancer going to come back?\u003c/p>\n\u003cp>“I wasn’t sleeping, I wasn’t exercising, I was marinating in my own sadness and fear of what this all meant,” he said. “I thought, ‘This is going to kill me.’”\u003c/p>\n\u003cp>Since his diagnosis, Swangard said he has had a greater understanding of his patients’ struggles. Occasionally, he holds their hands and tells them he has been where they are.\u003c/p>\n\u003cp>Earlier this year, a physician friend asked him if he’d be willing to join the California case. Swangard didn’t hesitate. He didn’t go into medicine to help dying people linger and wants to help change that approach — for his patients and for himself.\u003c/p>\n\u003cp>When he dies, Swangard said, he wants to be surrounded by people he loves. He doesn’t want to be in a drug-induced haze, nor consumed by worry about what’s next. He wants to be able to say goodbye.\u003c/p>\n\u003cp>“It is a little bit of a blessing to know how I might die,” he said. “I don’t think a lot of patients have insight into what to expect.”\u003c/p>\n\u003cp>These days, he wears a Buddhist prayer bracelet, a reminder to focus on the present. He cut his work hours, swims as often as he can and meditates regularly. At home, he stares out at the ocean, often watching dolphins pass by. He makes every effort to stay calm and healthy.\u003c/p>\n\u003cp>He is in remission but he knows that what happens with the cancer is largely outside his control. An MRI last year showed a small lesion in his liver, which doctors are watching closely.\u003c/p>\n\u003cp>“It’s this big unknown,” he said.\u003c/p>\n\u003cfigure id=\"attachment_24772\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/DSCN0347-e1427736893164.jpg\">\u003cimg class=\"size-medium wp-image-24772\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/DSCN0347-300x225.jpg\" alt=\"Retired San Francisco obstetrician Robert Liner, 70, is a plaintiff in a California lawsuit seeking to let doctors prescribe lethal medications to certain patients who want to die. (Anna Gorman/KHN)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Retired San Francisco obstetrician Robert Liner, 70, is a plaintiff in a California lawsuit seeking to let doctors prescribe lethal medications to certain patients who want to die. (Anna Gorman/KHN)\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. Robert Liner, a fellow plaintiff who only recently met Swangard, lives with the same uncertainty.\u003c/p>\n\u003cp>On his 69th birthday in May 2013, the retired obstetrician had a bad cough. He felt tired and short of breath. His wife took him to the hospital, where doctors discovered malignant masses on his kidneys — advanced-stage lymphoma.\u003c/p>\n\u003cp>After radiation and chemotherapy, the tumors shrank. He also is in remission. But if the cancer comes back, he said, “the prospects are not going to be good.”\u003c/p>\n\u003cp>He often thinks of a former patient, a 25-year-old woman with metastatic ovarian cancer. She wanted to die while she still was able to communicate. Liner wasn’t able to help ease her death because the law wouldn’t let him. “I felt like I’d failed her,” he said.\u003c/p>\n\u003cp>Years before his diagnosis, Liner, now 70, became involved with Compassion & Choices, an organization that promotes aid-in-dying. He has a shelf of books in his San Francisco home devoted to the subject: Being Mortal, Dying Right, Knocking on Heaven’s Door.\u003c/p>\n\u003cp>He keeps a stack of notecards with quotes about the end of life, which he often recites in speeches to church groups or senior centers. One reads, “The best preparation for death is a life well-lived.”\u003c/p>\n\u003cp>He believes having medication to hasten death helps terminally ill people live fully in their last weeks or months without being immobilized by fear. “If you are riddled with anxiety, you are not free to concentrate on what’s most meaningful to you,” he said.\u003c/p>\n\u003cp>Like Swangard, Liner doesn’t know if he would take the medication. He recently married the woman he calls his “beloved” and said he has lots of plans for his retirement years, including writing a screenplay and improving his piano playing.\u003c/p>\n\u003cp>“My wife says I’d be hanging on to life by my fingernails,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>State senators heard testimony today on a proposed bill that would allow doctors to prescribe lethal medication to terminally ill patients who request it. The testimony included a video from Brittany Maynard recorded 19 days before she took life-ending drugs.\u003c/p>\n\u003cp>In the video, Maynard implored California lawmakers to legalize “aid in dying.” Maynard, who had been diagnosed with terminal brain cancer, took lethal medication last year in Oregon, where the practice is legal.\u003c/p>\n\u003cp>\"The decision about how I end my dying process should be up to me and my family under a doctor's care. How dare the government make decisions or limit options for terminally ill people like me. Unfortunately, California law prevented me from getting the end-of life-option I deserved,\" said Maynard, who died Nov. 1 at age 29.\u003c!--more-->\u003c/p>\n\u003cp>Several people testified against the bill, including doctors who said the practice was incompatible with a physician’s role as a healer and warned that evidence from Belgium and the Netherlands, where physician-assisted suicide has been legal since 2002, showed that restrictions and safeguards meant to protect against abuse were difficult to enforce.\u003c/p>\n\u003cp>Disability rights advocates emphasized this point, arguing some people's lives would be ended without their consent, through mistakes or abuse.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It’s a 'deadly mix' to combine our broken health care system and assisted suicide, which would instantly become the cheapest treatment,\" said Marilyn Golden, senior policy analyst at the Disability Rights Education and Defense Fund. \"Direct coercion is not even necessary. If insurers deny, or even merely delay, expensive, life-sustaining treatment, patients are steered toward hastening their deaths. Do we think insurers will do the right thing, or the cheap thing?\"\u003c/p>\n\u003cp>Besides Oregon, the practice is legal in four other states: Montana, New Mexico, Vermont and Washington.\u003c/p>\n\u003cp>Advocates for aid-in-dying laws say legislators in at least 17 states have introduced similar measures this year. However, proposals in at least four states have already stalled for the year, and many have not yet received a hearing.\u003c/p>\n\u003cp>In the video, Maynard said people asked her if she had explored palliative sedation, a practice where the patient is given sedative drugs continuously until passing naturally, as an alternative to life-ending drugs. But Maynard said she found that option terrifying.\u003c/p>\n\u003cp>\"I may be minimally conscious, still suffering and unable to move or speak,\" she said.\u003c/p>\n\u003cp>Maynard's husband, Dan Diaz, who introduced the video at the hearing, said that he respects those who disagree with him and his wife, but that aid in dying should be an option for all Californians.\u003c/p>\n\u003cp>\"Even the staunchest of opponents might say, 'Well, I may not use it, but I would certainly want the option,'\" Diaz said as he choked back tears.\u003c/p>\n\u003cp>The Senate Health Committee voted 6-2 to approve the bill Wednesday. The bill moves next to the Senate Judiciary Committee for a hearing on April 7.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The Associated Press contributed to this report.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>State senators heard testimony today on a proposed bill that would allow doctors to prescribe lethal medication to terminally ill patients who request it. The testimony included a video from Brittany Maynard recorded 19 days before she took life-ending drugs.\u003c/p>\n\u003cp>In the video, Maynard implored California lawmakers to legalize “aid in dying.” Maynard, who had been diagnosed with terminal brain cancer, took lethal medication last year in Oregon, where the practice is legal.\u003c/p>\n\u003cp>\"The decision about how I end my dying process should be up to me and my family under a doctor's care. How dare the government make decisions or limit options for terminally ill people like me. Unfortunately, California law prevented me from getting the end-of life-option I deserved,\" said Maynard, who died Nov. 1 at age 29.\u003c!--more-->\u003c/p>\n\u003cp>Several people testified against the bill, including doctors who said the practice was incompatible with a physician’s role as a healer and warned that evidence from Belgium and the Netherlands, where physician-assisted suicide has been legal since 2002, showed that restrictions and safeguards meant to protect against abuse were difficult to enforce.\u003c/p>\n\u003cp>Disability rights advocates emphasized this point, arguing some people's lives would be ended without their consent, through mistakes or abuse.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It’s a 'deadly mix' to combine our broken health care system and assisted suicide, which would instantly become the cheapest treatment,\" said Marilyn Golden, senior policy analyst at the Disability Rights Education and Defense Fund. \"Direct coercion is not even necessary. If insurers deny, or even merely delay, expensive, life-sustaining treatment, patients are steered toward hastening their deaths. Do we think insurers will do the right thing, or the cheap thing?\"\u003c/p>\n\u003cp>Besides Oregon, the practice is legal in four other states: Montana, New Mexico, Vermont and Washington.\u003c/p>\n\u003cp>Advocates for aid-in-dying laws say legislators in at least 17 states have introduced similar measures this year. However, proposals in at least four states have already stalled for the year, and many have not yet received a hearing.\u003c/p>\n\u003cp>In the video, Maynard said people asked her if she had explored palliative sedation, a practice where the patient is given sedative drugs continuously until passing naturally, as an alternative to life-ending drugs. But Maynard said she found that option terrifying.\u003c/p>\n\u003cp>\"I may be minimally conscious, still suffering and unable to move or speak,\" she said.\u003c/p>\n\u003cp>Maynard's husband, Dan Diaz, who introduced the video at the hearing, said that he respects those who disagree with him and his wife, but that aid in dying should be an option for all Californians.\u003c/p>\n\u003cp>\"Even the staunchest of opponents might say, 'Well, I may not use it, but I would certainly want the option,'\" Diaz said as he choked back tears.\u003c/p>\n\u003cp>The Senate Health Committee voted 6-2 to approve the bill Wednesday. The bill moves next to the Senate Judiciary Committee for a hearing on April 7.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The Associated Press contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "On Medi-Cal Now, Lose Your House Later?",
"title": "On Medi-Cal Now, Lose Your House Later?",
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"content": "\u003cfigure id=\"attachment_24679\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/3917552574_e407cd25e0_o-e1427240331570.jpg\">\u003cimg class=\"size-large wp-image-24679\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/3917552574_e407cd25e0_o-640x489.jpg\" alt=\"(Erik Soderstrom via Flickr)\" width=\"640\" height=\"489\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Erik Soderstrom via Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Catherine Jarett ran into a nasty surprise after she sent a form to Medi-Cal on behalf of her clients. An estate attorney, Jarett was hired by the sons of an elderly Vallejo woman who had died. The woman had been enrolled in Medi-Cal, the state's insurance program for the poor, for more than 20 years.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Many on Medi-Cal learning that the state can file a claim against their estate after they die.\u003c/aside>\n\u003cp>After Jarett filed the form with Medi-Cal -- a death notice as required -- the state sent a bill for a hefty $76,349. Jarett was stunned. It was for the cost of \"health insurance, vision insurance, dental insurance,\" she said.\u003c/p>\n\u003cp>The bill was part of Medi-Cal's \"estate recovery program.\" Under a federal law not widely known to consumers, states can seize assets of Medi-Cal beneficiaries after they die. \"I was never aware of this wrinkle that they could recover for health insurance,\" Jarett said.\u003c!--more-->\u003c/p>\n\u003cp>Jarett's clients did not want to speak to reporters, but Jarett said they insisted their mother had not been to the doctor in years and had even died at home. Jarett said the charges included a breakdown by month of the state's payments to a managed care plan as part of Medi-Cal.\u003c/p>\n\u003cp>While federal law mandates that states recover for nursing home care, the law makes it optional that states recover for medical services -- doctor visits, hospital stays and the like -- for people 55 and over. Advocates say most states do not do this optional recovery, but California does.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It's an awful system, and it needs to be changed. It absolutely needs to be changed,\" said Pat McGinnis, executive director of California Advocates for Nursing Home Reform. Her group is sponsoring a bill, \u003ca href=\"http://www.leginfo.ca.gov/pub/15-16/bill/sen/sb_0001-0050/sb_33_bill_20141201_introduced.html\" target=\"_blank\">SB33\u003c/a>, introduced by state Sen. Ed Hernandez (D-West Covina), that would abolish this optional recovery. The bill will be heard by the Senate Health Committee on Wednesday.\u003c/p>\n\u003cp>Last year, a similar bill \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/25/for-some-medi-cal-might-mean-ultimately-losing-their-homes-estate-recovery/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/25/for-some-medi-cal-might-mean-ultimately-losing-their-homes-estate-recovery/\" target=\"_blank\">sailed through the Legislature\u003c/a>, but was ultimately vetoed by Gov. Jerry Brown. Still, in a statement last September when he vetoed the bill, Brown left an opening. He said estate protection might be a \"reasonable policy goal,\" but that the cost \"needs to considered alongside other worthwhile policy changes.\"\u003c/p>\n\u003cp>Figuring out that cost is a challenge. In 2013-14, the state recovered $61 million in 3,900 cases, said Carol Sloan with the Department of Health Care Services. But the state does not break down how much of that $61 million is for nursing home care and how much of it is for medical services.\u003c/p>\n\u003cp>For perspective, $17.8 billion in state general fund dollars went to Medi-Cal last year. The total budget for Medi-Cal is significantly more than that after adding in federal dollars, various taxes and more -- $85.7 billion.\u003c/p>\n\u003cp>\u003cstrong>'Leery' of Medi-Cal\u003c/strong>\u003c/p>\n\u003cp>Like the attorney Jarett, Anne-Louise Vernon, 60, of Campbell, had never heard of estate recovery. She had been \"so looking forward,\" she says, to signing up for insurance under the Affordable Care Act. Her income was so low that she did not qualify for subsidies to purchase insurance on the Covered California marketplace. Instead, she qualified for Medi-Cal.\u003c/p>\n\u003cp>Vernon said she was \"leery,\" and asked if there were strings attached. \"I was told, 'No, no, it's completely free.'\" She said it was some time later, when she was looking around online, that she found a reference on an FAQ page about assets being seized. She was furious.\u003c/p>\n\u003cp>\"So you're breaking the law if you don't have health insurance,\" Vernon said, in reference to Obamacare's \"individual mandate\" that everyone have health insurance, and then she was \"force(d) into Medi-Cal; they don't tell people it's a loan.\"\u003c/p>\n\u003cp>Vernon held onto her home years ago after a divorce, but said she was \"involuntarily retired\" and has been living on savings. She knows she could shelter her home but doesn't want to take that step. \"I'm 60! I'm not going to sign my house over to my kids at this age.\"\u003c/p>\n\u003cp>For other people, attorneys' fees to take the legal steps to shelter a property are a big issue. \"People who end up on Medi-Cal are poor people,\" said McGinnis. \"They usually have pretty poor houses, and they're the ones that usually cannot afford to pay an attorney $300-400 an hour.\"\u003c/p>\n\u003cp>\u003cstrong>'Collection Agency for the Feds'\u003c/strong>\u003c/p>\n\u003cp>Estate recovery has become a much bigger issue since the rollout of Obamacare started more than a year ago. Under the expansion of Medicaid, people earning up to 138 percent of the federal poverty level are eligible (in states like California that are participating in the expansion). But for those people, 100 percent of the cost of their health coverage is borne by the federal government for the first three years, drifting down to 90 percent after that, and any recovered money would be returned to the federal government.\u003c/p>\n\u003cp>\"What are we? A collection agency for the feds?\" asked McGinnis, who also says CANHR is hearing from consumers who will disenroll from Medi-Cal if the policy has not changed. Other advocates believe the policy is a barrier to enrollment for some people.\u003c/p>\n\u003cp>For now, Vernon is staying on Medi-Cal. Like 80 percent of Medi-Cal beneficiaries in California, she is enrolled in a managed care plan. When she wanted to know what her Medi-Cal coverage cost, she spent \"hours and hours on the phone\" calling both her managed care plan and the state, she says, and got the runaround from both of them. No one could tell her what her coverage cost.\u003c/p>\n\u003cp>Finally, an advocate sent her a link to the exact page on a state website where she could find out how to file a request for information -- with a $25 fee. She finally got an answer: $578.71 a month. If she stays on Medi-Cal for another five years until she's 65, when she becomes eligible for Medicare, the state will have paid almost $35,000 for her managed care premium. After she dies, the state could bill her estate for that amount -- or more, if she continues on Medi-Cal.\u003c/p>\n\u003cp>Ironically, if Vernon, and others like her, earned just a bit more money, they would qualify for heavily subsidized private insurance through the Covered California exchange. The state estimates that the \"per member per month\" premium for those\u003ca href=\"http://www.dhcs.ca.gov/dataandstats/reports/mcestimates/Documents/2014_May_Estimate/M1407_Regular_PC_Tab.pdf\" target=\"_blank\"> newly eligible for Medi-Cal is $620.98\u003c/a>, or nearly $75,000 over 10 years.\u003c/p>\n\u003cp>Vernon plugged her age and Zip code into the Covered California insurance calculator, but increased her income to $17,000 to see what would happen.\u003c/p>\n\u003cp>She found she could get a plan for as little as $31 a month, \"estate recovery free,\" she noted. These plans come with a $2,250 out-of-pocket limit, but even if a 55-year-old maxed that out every year, the 10-year total of deductible plus premium is $26,220 -- about $50,000 less than what would be accrued on average on Medi-Cal, with no estate recovery.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Sally Schilling, a student at the UC Berkeley Graduate School of Journalism produced this piece about estate recovery which aired Tuesday on PBS NewsHour:\u003c/em>\u003c/p>\n\u003cdiv>\u003ca class=\"embedly-card\" href=\"https://www.youtube.com/watch?v=WsARJYhzmKE\">The Medicaid bill that doesn't go away when you die\u003c/a>\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>\u003cem>\u003cstrong>Update:\u003c/strong> This post has been updated to reflect the amount for the average newly-eligible person to Medi-Cal. It is $620.98 per month. \u003c/em>\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24679\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/3917552574_e407cd25e0_o-e1427240331570.jpg\">\u003cimg class=\"size-large wp-image-24679\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/3917552574_e407cd25e0_o-640x489.jpg\" alt=\"(Erik Soderstrom via Flickr)\" width=\"640\" height=\"489\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Erik Soderstrom via Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Catherine Jarett ran into a nasty surprise after she sent a form to Medi-Cal on behalf of her clients. An estate attorney, Jarett was hired by the sons of an elderly Vallejo woman who had died. The woman had been enrolled in Medi-Cal, the state's insurance program for the poor, for more than 20 years.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Many on Medi-Cal learning that the state can file a claim against their estate after they die.\u003c/aside>\n\u003cp>After Jarett filed the form with Medi-Cal -- a death notice as required -- the state sent a bill for a hefty $76,349. Jarett was stunned. It was for the cost of \"health insurance, vision insurance, dental insurance,\" she said.\u003c/p>\n\u003cp>The bill was part of Medi-Cal's \"estate recovery program.\" Under a federal law not widely known to consumers, states can seize assets of Medi-Cal beneficiaries after they die. \"I was never aware of this wrinkle that they could recover for health insurance,\" Jarett said.\u003c!--more-->\u003c/p>\n\u003cp>Jarett's clients did not want to speak to reporters, but Jarett said they insisted their mother had not been to the doctor in years and had even died at home. Jarett said the charges included a breakdown by month of the state's payments to a managed care plan as part of Medi-Cal.\u003c/p>\n\u003cp>While federal law mandates that states recover for nursing home care, the law makes it optional that states recover for medical services -- doctor visits, hospital stays and the like -- for people 55 and over. Advocates say most states do not do this optional recovery, but California does.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It's an awful system, and it needs to be changed. It absolutely needs to be changed,\" said Pat McGinnis, executive director of California Advocates for Nursing Home Reform. Her group is sponsoring a bill, \u003ca href=\"http://www.leginfo.ca.gov/pub/15-16/bill/sen/sb_0001-0050/sb_33_bill_20141201_introduced.html\" target=\"_blank\">SB33\u003c/a>, introduced by state Sen. Ed Hernandez (D-West Covina), that would abolish this optional recovery. The bill will be heard by the Senate Health Committee on Wednesday.\u003c/p>\n\u003cp>Last year, a similar bill \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/25/for-some-medi-cal-might-mean-ultimately-losing-their-homes-estate-recovery/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/25/for-some-medi-cal-might-mean-ultimately-losing-their-homes-estate-recovery/\" target=\"_blank\">sailed through the Legislature\u003c/a>, but was ultimately vetoed by Gov. Jerry Brown. Still, in a statement last September when he vetoed the bill, Brown left an opening. He said estate protection might be a \"reasonable policy goal,\" but that the cost \"needs to considered alongside other worthwhile policy changes.\"\u003c/p>\n\u003cp>Figuring out that cost is a challenge. In 2013-14, the state recovered $61 million in 3,900 cases, said Carol Sloan with the Department of Health Care Services. But the state does not break down how much of that $61 million is for nursing home care and how much of it is for medical services.\u003c/p>\n\u003cp>For perspective, $17.8 billion in state general fund dollars went to Medi-Cal last year. The total budget for Medi-Cal is significantly more than that after adding in federal dollars, various taxes and more -- $85.7 billion.\u003c/p>\n\u003cp>\u003cstrong>'Leery' of Medi-Cal\u003c/strong>\u003c/p>\n\u003cp>Like the attorney Jarett, Anne-Louise Vernon, 60, of Campbell, had never heard of estate recovery. She had been \"so looking forward,\" she says, to signing up for insurance under the Affordable Care Act. Her income was so low that she did not qualify for subsidies to purchase insurance on the Covered California marketplace. Instead, she qualified for Medi-Cal.\u003c/p>\n\u003cp>Vernon said she was \"leery,\" and asked if there were strings attached. \"I was told, 'No, no, it's completely free.'\" She said it was some time later, when she was looking around online, that she found a reference on an FAQ page about assets being seized. She was furious.\u003c/p>\n\u003cp>\"So you're breaking the law if you don't have health insurance,\" Vernon said, in reference to Obamacare's \"individual mandate\" that everyone have health insurance, and then she was \"force(d) into Medi-Cal; they don't tell people it's a loan.\"\u003c/p>\n\u003cp>Vernon held onto her home years ago after a divorce, but said she was \"involuntarily retired\" and has been living on savings. She knows she could shelter her home but doesn't want to take that step. \"I'm 60! I'm not going to sign my house over to my kids at this age.\"\u003c/p>\n\u003cp>For other people, attorneys' fees to take the legal steps to shelter a property are a big issue. \"People who end up on Medi-Cal are poor people,\" said McGinnis. \"They usually have pretty poor houses, and they're the ones that usually cannot afford to pay an attorney $300-400 an hour.\"\u003c/p>\n\u003cp>\u003cstrong>'Collection Agency for the Feds'\u003c/strong>\u003c/p>\n\u003cp>Estate recovery has become a much bigger issue since the rollout of Obamacare started more than a year ago. Under the expansion of Medicaid, people earning up to 138 percent of the federal poverty level are eligible (in states like California that are participating in the expansion). But for those people, 100 percent of the cost of their health coverage is borne by the federal government for the first three years, drifting down to 90 percent after that, and any recovered money would be returned to the federal government.\u003c/p>\n\u003cp>\"What are we? A collection agency for the feds?\" asked McGinnis, who also says CANHR is hearing from consumers who will disenroll from Medi-Cal if the policy has not changed. Other advocates believe the policy is a barrier to enrollment for some people.\u003c/p>\n\u003cp>For now, Vernon is staying on Medi-Cal. Like 80 percent of Medi-Cal beneficiaries in California, she is enrolled in a managed care plan. When she wanted to know what her Medi-Cal coverage cost, she spent \"hours and hours on the phone\" calling both her managed care plan and the state, she says, and got the runaround from both of them. No one could tell her what her coverage cost.\u003c/p>\n\u003cp>Finally, an advocate sent her a link to the exact page on a state website where she could find out how to file a request for information -- with a $25 fee. She finally got an answer: $578.71 a month. If she stays on Medi-Cal for another five years until she's 65, when she becomes eligible for Medicare, the state will have paid almost $35,000 for her managed care premium. After she dies, the state could bill her estate for that amount -- or more, if she continues on Medi-Cal.\u003c/p>\n\u003cp>Ironically, if Vernon, and others like her, earned just a bit more money, they would qualify for heavily subsidized private insurance through the Covered California exchange. The state estimates that the \"per member per month\" premium for those\u003ca href=\"http://www.dhcs.ca.gov/dataandstats/reports/mcestimates/Documents/2014_May_Estimate/M1407_Regular_PC_Tab.pdf\" target=\"_blank\"> newly eligible for Medi-Cal is $620.98\u003c/a>, or nearly $75,000 over 10 years.\u003c/p>\n\u003cp>Vernon plugged her age and Zip code into the Covered California insurance calculator, but increased her income to $17,000 to see what would happen.\u003c/p>\n\u003cp>She found she could get a plan for as little as $31 a month, \"estate recovery free,\" she noted. These plans come with a $2,250 out-of-pocket limit, but even if a 55-year-old maxed that out every year, the 10-year total of deductible plus premium is $26,220 -- about $50,000 less than what would be accrued on average on Medi-Cal, with no estate recovery.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Sally Schilling, a student at the UC Berkeley Graduate School of Journalism produced this piece about estate recovery which aired Tuesday on PBS NewsHour:\u003c/em>\u003c/p>\n\u003cdiv>\u003ca class=\"embedly-card\" href=\"https://www.youtube.com/watch?v=WsARJYhzmKE\">The Medicaid bill that doesn't go away when you die\u003c/a>\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>\u003cem>\u003cstrong>Update:\u003c/strong> This post has been updated to reflect the amount for the average newly-eligible person to Medi-Cal. It is $620.98 per month. \u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Millions Need to Be On Alert for Medi-Cal Renewal",
"title": "Millions Need to Be On Alert for Medi-Cal Renewal",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_24635\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Screen-Shot-2015-03-19-at-12.06.30-PM.png\">\u003cimg class=\"size-large wp-image-24635\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Screen-Shot-2015-03-19-at-12.06.30-PM-640x321.png\" alt=\"(Screen shot of California's Department of Health Care Services website)\" width=\"640\" height=\"321\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Screen shot of California's Department of Health Care Services website)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Emily Bazar,\u003c/strong> \u003ca title=\"http://centerforhealthreporting.org\" href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>I spend the majority of my time (and space) writing about the new state health insurance exchange, Covered California.\u003c/p>\n\u003cp>But the behemoth in California’s Affordable Care Act implementation is Medi-Cal, the state’s decades-old version of the federal Medicaid program, which provides publicly funded insurance to low-income residents.\u003c/p>\n\u003cp>About 12 million Californians are in Medi-Cal now. That’s roughly one in three state residents. By comparison, about 1.4 million Californians are enrolled in Covered California.\u003c/p>\n\u003cp>Given its size, Medi-Cal’s annual renewal process is now one of its greatest challenges.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Last year’s process was new, messy and confusing, and many Californians –- we’re not being told how many –- got dropped from the program.\u003c/p>\n\u003cp>This year, Medi-Cal has changed the process again. Already, people are complaining that they’re getting dropped when they shouldn’t be.\u003c/p>\n\u003cp>\u003cstrong>Q: I never received the Medi-Cal renewal application but I just got a notice saying I’m getting kicked off because I didn’t turn it in. What should I do?\u003c/strong>\u003c/p>\n\u003cp>A: Michael Gong, an Oakland graduate student, joined Medi-Cal last year when California expanded Medi-Cal eligibility (through the Affordable Care Act) to childless adults and those with higher incomes than before.\u003c/p>\n\u003cp>Under the new rules, individuals and families earning up to 138 percent of the federal poverty level can qualify. This year, that equates to about $16,200 for a single adult.\u003c/p>\n\u003cp>When Gong received the letter in late January saying he was going to be dropped, he began a month-long quest to get reinstated.\u003c/p>\n\u003cp>He submitted his renewal materials, which is allowed within a grace period. But in response, he received another termination letter in mid-February saying that he can’t be in Medi-Cal because he’s not a California resident.\u003c/p>\n\u003cp>(Whether or not you think Oakland belongs in California, it is generally accepted to be within our borders.)\u003c/p>\n\u003cp>At that point, he and his mother, Judyth Collin, made dozens of unanswered calls to county workers, (county workers process Medi-Cal applications and determine eligibility) and visited county offices.\u003c/p>\n\u003cp>Finally, Collin reached a supervisor by phone who helped Gong get back on Medi-Cal in early March, she says.\u003c/p>\n\u003cp>Gong’s problems aren’t isolated.\u003c/p>\n\u003cp>“We’re hearing from people who have been cut off who have turned in their forms,” says Jen Flory, senior attorney at the Western Center on Law and Poverty. “And we’re hearing from people who are trying to contact their county workers and are having trouble getting through.”\u003c/p>\n\u003cp>Theoretically, this year’s renewal process should be easier than last year’s. If you enrolled in Medi-Cal or completed renewal forms last year and your county can determine that your eligibility hasn’t changed, you should receive a letter this year confirming your enrollment for another year.\u003c/p>\n\u003cp>“For the first time, we’re not sending out an enormous blank packet for people to fill out,” says Cathy Senderling-McDonald, deputy executive director of the County Welfare Directors Association.\u003c/p>\n\u003cp>Some people may not qualify for auto-renewal and will receive a notice that requests additional information, such as proof of income or state residency. If you receive that, you will have at least 30 days to respond, she says.\u003c/p>\n\u003cp>Roughly 1 million Californians will be asked to renew each month, according to the state Department of Health Care Services (DHCS), which administers Medi-Cal at the state level.\u003c/p>\n\u003cp>The stakes are high, but it’s hard to gauge the impact because Medi-Cal officials decline to say how many people have been dropped from the program as a result of the renewal process this year and last.\u003c/p>\n\u003cp>“These data are not available currently,” says Tony Cava of DHCS.\u003c/p>\n\u003cp>Here’s my advice: If you’re in Gong’s situation and get a termination notice because you didn’t submit renewal information – whether or not it was your fault – get the paperwork in as soon as possible.\u003c/p>\n\u003cp>You have 90 days from the date of termination to submit that information. If you do and you’re still eligible for the program, you will be reinstated retroactive to the date you were kicked out, Flory says.\u003c/p>\n\u003cp>Next, reach out to your county case worker. I know, easier said than done.\u003c/p>\n\u003cp>The roughly 15,000 county workers dedicated to Medi-Cal are overwhelmed. They’re juggling an onslaught of new applications, the renewal process (some of last year’s load was pushed into this year), plus persistent computer problems.\u003c/p>\n\u003cp>For instance, the state computer system won’t allow county workers to deny applications themselves or drop people who are ineligible, Senderling-McDonald says. Which leads to backlogs and mistakes.\u003c/p>\n\u003cp>“There’s a lot of manual work that counties are still doing to get around the issues in the computer system,” she says.\u003c/p>\n\u003cp>But there’s hope. The state is working on the technical problems. By July, county workers are scheduled to have the ability to deny applications on their own, Senderling-McDonald says.\u003c/p>\n\u003cp>There’s also $150 million in the current-year state budget to beef up county Medi-Cal resources, including money for overtime pay, she says.\u003c/p>\n\u003cp>Until things get better:\u003c/p>\n\u003cul>\n\u003cli>Don’t ignore letters you receive from Medi-Cal. Because the forms are changing, your annual renewal probably won’t look like it has in the past.\u003c/li>\n\u003cli>Ask for a supervisor if you’re having trouble reaching someone at your county human services agency. Be persistent.\u003c/li>\n\u003cli>Request an eligibility hearing by calling 800-952-5253 if receive a notice that you’ll be losing your benefits. Doing this will flag your case for attention and it may get resolved before your hearing date.\u003c/li>\n\u003c/ul>\n\u003cp>\u003cem> Questions for Emily: AskEmily@usc.edu\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem> The CHCF Center for Health Reporting partners with news organizations to cover California health policy. Located at the USC Annenberg School for Communication and Journalism, it is funded by the nonpartisan California HealthCare Foundation.\u003c/em>\u003c/p>\n\n",
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"excerpt": "The system is incorrectly dropping people from coverage. Here's what to do if that happens to you.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24635\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Screen-Shot-2015-03-19-at-12.06.30-PM.png\">\u003cimg class=\"size-large wp-image-24635\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Screen-Shot-2015-03-19-at-12.06.30-PM-640x321.png\" alt=\"(Screen shot of California's Department of Health Care Services website)\" width=\"640\" height=\"321\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Screen shot of California's Department of Health Care Services website)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Emily Bazar,\u003c/strong> \u003ca title=\"http://centerforhealthreporting.org\" href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>I spend the majority of my time (and space) writing about the new state health insurance exchange, Covered California.\u003c/p>\n\u003cp>But the behemoth in California’s Affordable Care Act implementation is Medi-Cal, the state’s decades-old version of the federal Medicaid program, which provides publicly funded insurance to low-income residents.\u003c/p>\n\u003cp>About 12 million Californians are in Medi-Cal now. That’s roughly one in three state residents. By comparison, about 1.4 million Californians are enrolled in Covered California.\u003c/p>\n\u003cp>Given its size, Medi-Cal’s annual renewal process is now one of its greatest challenges.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Last year’s process was new, messy and confusing, and many Californians –- we’re not being told how many –- got dropped from the program.\u003c/p>\n\u003cp>This year, Medi-Cal has changed the process again. Already, people are complaining that they’re getting dropped when they shouldn’t be.\u003c/p>\n\u003cp>\u003cstrong>Q: I never received the Medi-Cal renewal application but I just got a notice saying I’m getting kicked off because I didn’t turn it in. What should I do?\u003c/strong>\u003c/p>\n\u003cp>A: Michael Gong, an Oakland graduate student, joined Medi-Cal last year when California expanded Medi-Cal eligibility (through the Affordable Care Act) to childless adults and those with higher incomes than before.\u003c/p>\n\u003cp>Under the new rules, individuals and families earning up to 138 percent of the federal poverty level can qualify. This year, that equates to about $16,200 for a single adult.\u003c/p>\n\u003cp>When Gong received the letter in late January saying he was going to be dropped, he began a month-long quest to get reinstated.\u003c/p>\n\u003cp>He submitted his renewal materials, which is allowed within a grace period. But in response, he received another termination letter in mid-February saying that he can’t be in Medi-Cal because he’s not a California resident.\u003c/p>\n\u003cp>(Whether or not you think Oakland belongs in California, it is generally accepted to be within our borders.)\u003c/p>\n\u003cp>At that point, he and his mother, Judyth Collin, made dozens of unanswered calls to county workers, (county workers process Medi-Cal applications and determine eligibility) and visited county offices.\u003c/p>\n\u003cp>Finally, Collin reached a supervisor by phone who helped Gong get back on Medi-Cal in early March, she says.\u003c/p>\n\u003cp>Gong’s problems aren’t isolated.\u003c/p>\n\u003cp>“We’re hearing from people who have been cut off who have turned in their forms,” says Jen Flory, senior attorney at the Western Center on Law and Poverty. “And we’re hearing from people who are trying to contact their county workers and are having trouble getting through.”\u003c/p>\n\u003cp>Theoretically, this year’s renewal process should be easier than last year’s. If you enrolled in Medi-Cal or completed renewal forms last year and your county can determine that your eligibility hasn’t changed, you should receive a letter this year confirming your enrollment for another year.\u003c/p>\n\u003cp>“For the first time, we’re not sending out an enormous blank packet for people to fill out,” says Cathy Senderling-McDonald, deputy executive director of the County Welfare Directors Association.\u003c/p>\n\u003cp>Some people may not qualify for auto-renewal and will receive a notice that requests additional information, such as proof of income or state residency. If you receive that, you will have at least 30 days to respond, she says.\u003c/p>\n\u003cp>Roughly 1 million Californians will be asked to renew each month, according to the state Department of Health Care Services (DHCS), which administers Medi-Cal at the state level.\u003c/p>\n\u003cp>The stakes are high, but it’s hard to gauge the impact because Medi-Cal officials decline to say how many people have been dropped from the program as a result of the renewal process this year and last.\u003c/p>\n\u003cp>“These data are not available currently,” says Tony Cava of DHCS.\u003c/p>\n\u003cp>Here’s my advice: If you’re in Gong’s situation and get a termination notice because you didn’t submit renewal information – whether or not it was your fault – get the paperwork in as soon as possible.\u003c/p>\n\u003cp>You have 90 days from the date of termination to submit that information. If you do and you’re still eligible for the program, you will be reinstated retroactive to the date you were kicked out, Flory says.\u003c/p>\n\u003cp>Next, reach out to your county case worker. I know, easier said than done.\u003c/p>\n\u003cp>The roughly 15,000 county workers dedicated to Medi-Cal are overwhelmed. They’re juggling an onslaught of new applications, the renewal process (some of last year’s load was pushed into this year), plus persistent computer problems.\u003c/p>\n\u003cp>For instance, the state computer system won’t allow county workers to deny applications themselves or drop people who are ineligible, Senderling-McDonald says. Which leads to backlogs and mistakes.\u003c/p>\n\u003cp>“There’s a lot of manual work that counties are still doing to get around the issues in the computer system,” she says.\u003c/p>\n\u003cp>But there’s hope. The state is working on the technical problems. By July, county workers are scheduled to have the ability to deny applications on their own, Senderling-McDonald says.\u003c/p>\n\u003cp>There’s also $150 million in the current-year state budget to beef up county Medi-Cal resources, including money for overtime pay, she says.\u003c/p>\n\u003cp>Until things get better:\u003c/p>\n\u003cul>\n\u003cli>Don’t ignore letters you receive from Medi-Cal. Because the forms are changing, your annual renewal probably won’t look like it has in the past.\u003c/li>\n\u003cli>Ask for a supervisor if you’re having trouble reaching someone at your county human services agency. Be persistent.\u003c/li>\n\u003cli>Request an eligibility hearing by calling 800-952-5253 if receive a notice that you’ll be losing your benefits. Doing this will flag your case for attention and it may get resolved before your hearing date.\u003c/li>\n\u003c/ul>\n\u003cp>\u003cem> Questions for Emily: AskEmily@usc.edu\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem> The CHCF Center for Health Reporting partners with news organizations to cover California health policy. Located at the USC Annenberg School for Communication and Journalism, it is funded by the nonpartisan California HealthCare Foundation.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Needs More Primary Care Docs, But Residency Slots Threatened",
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"content": "\u003cfigure id=\"attachment_10770\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/PlevinPhoto-e1426871743106.jpg\">\u003cimg class=\"wp-image-10770 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/PlevinPhoto-e1426871743106.jpg\" alt=\"Dr. Peter Broderick of Doctors Medical Center in Modesto examines a patient's x-ray while family practice medical residents look on. (Rebecca Plevin/KVPR)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/02/PlevinPhoto-e1426871743106.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/02/PlevinPhoto-e1426871743106-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/02/PlevinPhoto-e1426871743106-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Peter Broderick of Doctors Medical Center in Modesto examines a patient's x-ray while family practice medical residents look on. (Rebecca Plevin/KVPR)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca title=\"http://www.californiahealthline.org/capitol-desk/2015/3/residency-training-slots-may-evaporate\" href=\"http://www.californiahealthline.org/capitol-desk/2015/3/residency-training-slots-may-evaporate\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>Today is a huge day for graduating medical students. It's Match Day -- the day they find out where they're going for residency programs -- the training years between medical school and practice.\u003c/p>\n\u003cp>In California, there are 140 residency slots every year in the family practice specialty. That number may diminish, given the pending loss of four funding sources designed to encourage California medical students to join family-practice residencies, particularly in underserved areas of the state.\u003c/p>\n\u003cp>According to Del Morris, president of the California Academy of Family Physicians, California faces a loss of $50 million from the end of these four programs:\u003c!--more-->\u003c/p>\n\u003cul>\n\u003cli>The federal government's \u003ca title=\"http://bhpr.hrsa.gov/grants/teachinghealthcenters/\" href=\"http://bhpr.hrsa.gov/grants/teachinghealthcenters/\" target=\"_blank\">Teaching Health Center Graduate Medical Education\u003c/a> grant program is set to expire this year\u003c/li>\n\u003cli>Another federal program -- the \u003ca title=\"http://bhpr.hrsa.gov/grants/medicine/pcre.html\" href=\"http://bhpr.hrsa.gov/grants/medicine/pcre.html\" target=\"_blank\">Primary Care Residency Expansion\u003c/a> is also ending. It awarded about $18 million in grants in California last year to create new resident positions in primary care residency programs\u003c/li>\n\u003cli>A \u003ca title=\"http://tcenews.calendow.org/releases/the-california-endowment-commits-78-2-million-in-grants-to-increase-california-s-health-care-workforce\" href=\"http://tcenews.calendow.org/releases/the-california-endowment-commits-78-2-million-in-grants-to-increase-california-s-health-care-workforce\" target=\"_blank\">California Endowment grant\u003c/a> supporting the California workforce training program known as \u003ca title=\"http://www.ccahn.org/post/song-brown-residency-program\" href=\"http://www.ccahn.org/post/song-brown-residency-program\" target=\"_blank\">Song-Brown\u003c/a> -- providing $21 million over the past three years -- ends in 2016\u003c/li>\n\u003cli>$4 million appropriated last year by the Legislature to add into the Song-Brown fund was a one-time infusion of funds.\u003c/li>\n\u003c/ul>\n\u003cp>Those programs helped fund residency slots and encouraged California medical school graduates to remain in the state for residency. Many people set up practices near their residency program, Morris said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>No one knows how many residency slots in California might be lost because of dried-up funding, but the \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/02/25/new-approach-to-medical-residency-may-ease-doctor-shortage-in-central-valley/\" href=\"http://ww2.kqed.org/stateofhealth/2013/02/25/new-approach-to-medical-residency-may-ease-doctor-shortage-in-central-valley/\" target=\"_blank\">Sierra Vista Family Medicine Residency Program\u003c/a> in Fresno won't be enrolling a class of residents this year because they can't afford it, given that federal funding is expected to end.\u003c/p>\n\u003cp>According to Norma Forbes, executive director of Fresno Healthy Communities Access Partners, \"it is estimated 66 percent (of California's Teaching Health Center programs) are unlikely to be able to support current residency positions in the future without continued federal funding.\" That statistic came from a survey of 60 THC residency programs.\u003c/p>\n\u003cp>Even the status quo of 140 residency slots won't nearly approach the need for primary care physicians in California, Morris said, especially in rural and urban underserved areas.\u003c/p>\n\u003cp>\"That's just not enough,\" Morris said. \"One-third of physicians in the state will retire by 2030, our population is growing and millions more Californians have gained coverage under health care reform.\"\u003c/p>\n\u003cp>California can't afford to lose more medical students to other states, he said.\u003c/p>\n\u003cp>On the state level, Morris said his association is working with the Legislature on budget language that could appropriate an additional $8 million to put into the Song-Brown Fund.\u003c/p>\n\u003cp>On the national front, California Rep. Doug LaMalfa (R-Redding) is leading a bipartisan effort to fund the Teaching Health Center program.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Californians' health depends in part on a sufficient number of primary care physicians to treat them,\" Morris said. \"Our state must increase its family medicine training capacity.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_10770\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/PlevinPhoto-e1426871743106.jpg\">\u003cimg class=\"wp-image-10770 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/PlevinPhoto-e1426871743106.jpg\" alt=\"Dr. Peter Broderick of Doctors Medical Center in Modesto examines a patient's x-ray while family practice medical residents look on. (Rebecca Plevin/KVPR)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/02/PlevinPhoto-e1426871743106.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/02/PlevinPhoto-e1426871743106-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/02/PlevinPhoto-e1426871743106-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Peter Broderick of Doctors Medical Center in Modesto examines a patient's x-ray while family practice medical residents look on. (Rebecca Plevin/KVPR)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca title=\"http://www.californiahealthline.org/capitol-desk/2015/3/residency-training-slots-may-evaporate\" href=\"http://www.californiahealthline.org/capitol-desk/2015/3/residency-training-slots-may-evaporate\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>Today is a huge day for graduating medical students. It's Match Day -- the day they find out where they're going for residency programs -- the training years between medical school and practice.\u003c/p>\n\u003cp>In California, there are 140 residency slots every year in the family practice specialty. That number may diminish, given the pending loss of four funding sources designed to encourage California medical students to join family-practice residencies, particularly in underserved areas of the state.\u003c/p>\n\u003cp>According to Del Morris, president of the California Academy of Family Physicians, California faces a loss of $50 million from the end of these four programs:\u003c!--more-->\u003c/p>\n\u003cul>\n\u003cli>The federal government's \u003ca title=\"http://bhpr.hrsa.gov/grants/teachinghealthcenters/\" href=\"http://bhpr.hrsa.gov/grants/teachinghealthcenters/\" target=\"_blank\">Teaching Health Center Graduate Medical Education\u003c/a> grant program is set to expire this year\u003c/li>\n\u003cli>Another federal program -- the \u003ca title=\"http://bhpr.hrsa.gov/grants/medicine/pcre.html\" href=\"http://bhpr.hrsa.gov/grants/medicine/pcre.html\" target=\"_blank\">Primary Care Residency Expansion\u003c/a> is also ending. It awarded about $18 million in grants in California last year to create new resident positions in primary care residency programs\u003c/li>\n\u003cli>A \u003ca title=\"http://tcenews.calendow.org/releases/the-california-endowment-commits-78-2-million-in-grants-to-increase-california-s-health-care-workforce\" href=\"http://tcenews.calendow.org/releases/the-california-endowment-commits-78-2-million-in-grants-to-increase-california-s-health-care-workforce\" target=\"_blank\">California Endowment grant\u003c/a> supporting the California workforce training program known as \u003ca title=\"http://www.ccahn.org/post/song-brown-residency-program\" href=\"http://www.ccahn.org/post/song-brown-residency-program\" target=\"_blank\">Song-Brown\u003c/a> -- providing $21 million over the past three years -- ends in 2016\u003c/li>\n\u003cli>$4 million appropriated last year by the Legislature to add into the Song-Brown fund was a one-time infusion of funds.\u003c/li>\n\u003c/ul>\n\u003cp>Those programs helped fund residency slots and encouraged California medical school graduates to remain in the state for residency. Many people set up practices near their residency program, Morris said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>No one knows how many residency slots in California might be lost because of dried-up funding, but the \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/02/25/new-approach-to-medical-residency-may-ease-doctor-shortage-in-central-valley/\" href=\"http://ww2.kqed.org/stateofhealth/2013/02/25/new-approach-to-medical-residency-may-ease-doctor-shortage-in-central-valley/\" target=\"_blank\">Sierra Vista Family Medicine Residency Program\u003c/a> in Fresno won't be enrolling a class of residents this year because they can't afford it, given that federal funding is expected to end.\u003c/p>\n\u003cp>According to Norma Forbes, executive director of Fresno Healthy Communities Access Partners, \"it is estimated 66 percent (of California's Teaching Health Center programs) are unlikely to be able to support current residency positions in the future without continued federal funding.\" That statistic came from a survey of 60 THC residency programs.\u003c/p>\n\u003cp>Even the status quo of 140 residency slots won't nearly approach the need for primary care physicians in California, Morris said, especially in rural and urban underserved areas.\u003c/p>\n\u003cp>\"That's just not enough,\" Morris said. \"One-third of physicians in the state will retire by 2030, our population is growing and millions more Californians have gained coverage under health care reform.\"\u003c/p>\n\u003cp>California can't afford to lose more medical students to other states, he said.\u003c/p>\n\u003cp>On the state level, Morris said his association is working with the Legislature on budget language that could appropriate an additional $8 million to put into the Song-Brown Fund.\u003c/p>\n\u003cp>On the national front, California Rep. Doug LaMalfa (R-Redding) is leading a bipartisan effort to fund the Teaching Health Center program.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Californians' health depends in part on a sufficient number of primary care physicians to treat them,\" Morris said. \"Our state must increase its family medicine training capacity.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_24642\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/iStock_000005253776_Large-e1426803853557.jpg\">\u003cimg class=\"wp-image-24642 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/iStock_000005253776_Large-640x480.jpg\" alt=\"stethoscope and dollar\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong> By Rebecca Plevin, \u003ca title=\"http://www.scpr.org/blogs/health/2015/03/19/17993/state-lawmakers-are-concerned-about-health-costs/\" href=\"http://www.scpr.org/blogs/health/2015/03/19/17993/state-lawmakers-are-concerned-about-health-costs/\" target=\"_blank\">KPCC\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>Last spring, KPCC, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\">KQED \u003c/a>and \u003ca href=\"http://clearhealthcosts.com/\">ClearHealthCosts.com\u003c/a> teamed up and started a conversation about health costs in California.\u003c/p>\n\u003cp>We knew a growing number of people wanted to shop around for affordable \u003ca href=\"http://www.scpr.org/blogs/health/2014/08/11/17119/your-mammogram-s-hefty-price-tag-explained/\" target=\"_blank\">mammograms\u003c/a>, \u003ca href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\">MRI's\u003c/a> and other procedures. But it was nearly impossible to discover the costs. As part of our project, called \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">#PriceCheck\u003c/a>, we invited you to share what you paid for certain procedures. In the process, we began building a database of health costs.\u003c/p>\n\u003cp>On Wednesday, the California State Senate Committee on Health picked up that conversation.\u003c/p>\n\u003cp>During a hearing at the state Capitol, doctors, researchers and consumers told lawmakers that despite the federal health care law, health costs are still a barrier to care.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Deductibles as deterrents\u003c/strong>\u003c/p>\n\u003cp>More Californians now have high-deductible health plans, Health Access executive director Anthony Wright told the legislators. The unintended consequence of this, he said, is people are reducing both unnecessary -- and necessary -- health care, because they can't shoulder a large share of their bill.\u003c/p>\n\u003cp>High deductibles, as well as high premiums and co-pays, \"serve as a deterrent for people accessing health care,\" he said. (\u003cem>Impatient\u003c/em> reported on \u003ca href=\"http://www.scpr.org/blogs/health/2015/03/11/17979/high-deductible-plans-hidden-costs-obvious-frustra/\">this phenomenon\u003c/a> last week.)\u003c/p>\n\u003cp>This situation is compounded by the fact that many people who are newly insured with cheaper higher-deductible plans \"don't have a lot of experience with the intricacies of the health care system,\" said Neeraj Sood, director of research for USC's Schaeffer Center for Health Policy & Economics.\u003c/p>\n\u003cp>They might know that they should ask the price of a procedure, but patients are \"intimidated to find out how much something is going to cost,\" he said.\u003c/p>\n\u003cp>Sood said he's heard that people can't afford their co-pays and deductibles, and are going into medical debt. And that's a problem both for patients and for doctors, who aren't getting paid.\u003c/p>\n\u003cp>\u003cstrong>'The Future is Here'\u003c/strong>\u003c/p>\n\u003cp>It was against this backdrop that our partner, Jeanne Pinder, founder and CEO of ClearHealthCosts.com, shared a more optimistic perspective: \"The future is here,\" she told the committee. \"People are actually shopping for health care.\"\u003c/p>\n\u003cp>She explained that hundreds and hundreds of people have shared their health costs with #PriceCheck. The reason?\u003c/p>\n\u003cp>\"People are really upset about the lack of cost transparency in the health care system,\" she said. \"They want to talk about it and they want a way to make a difference.\"\u003c/p>\n\u003cp>For the most part, she said, it's women who are doing the bulk of this health care shopping. They're the ones making most health-related decisions -- regarding reproductive health, kids' health, elder care -- and they're the ones who are on board with searching for affordable health care, added Pinder.\u003c/p>\n\u003cp>\u003cstrong>Relaunching PriceCheck\u003c/strong>\u003c/p>\n\u003cp>If you're upset about health costs, we have more good news for you: Starting next month, we are re-launching #PriceCheck. More details about that coming soon!\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In the meantime, if you've paid an arm and a leg for a recent procedure, tell us about it in the comments section below.\u003c/p>\n\n",
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"excerpt": "PriceCheck partner Jeanne Pinder, of ClearHealthCosts.com, was invited to testify before the state's Senate Committee on Health.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24642\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/iStock_000005253776_Large-e1426803853557.jpg\">\u003cimg class=\"wp-image-24642 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/iStock_000005253776_Large-640x480.jpg\" alt=\"stethoscope and dollar\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong> By Rebecca Plevin, \u003ca title=\"http://www.scpr.org/blogs/health/2015/03/19/17993/state-lawmakers-are-concerned-about-health-costs/\" href=\"http://www.scpr.org/blogs/health/2015/03/19/17993/state-lawmakers-are-concerned-about-health-costs/\" target=\"_blank\">KPCC\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>Last spring, KPCC, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\">KQED \u003c/a>and \u003ca href=\"http://clearhealthcosts.com/\">ClearHealthCosts.com\u003c/a> teamed up and started a conversation about health costs in California.\u003c/p>\n\u003cp>We knew a growing number of people wanted to shop around for affordable \u003ca href=\"http://www.scpr.org/blogs/health/2014/08/11/17119/your-mammogram-s-hefty-price-tag-explained/\" target=\"_blank\">mammograms\u003c/a>, \u003ca href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\">MRI's\u003c/a> and other procedures. But it was nearly impossible to discover the costs. As part of our project, called \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">#PriceCheck\u003c/a>, we invited you to share what you paid for certain procedures. In the process, we began building a database of health costs.\u003c/p>\n\u003cp>On Wednesday, the California State Senate Committee on Health picked up that conversation.\u003c/p>\n\u003cp>During a hearing at the state Capitol, doctors, researchers and consumers told lawmakers that despite the federal health care law, health costs are still a barrier to care.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Deductibles as deterrents\u003c/strong>\u003c/p>\n\u003cp>More Californians now have high-deductible health plans, Health Access executive director Anthony Wright told the legislators. The unintended consequence of this, he said, is people are reducing both unnecessary -- and necessary -- health care, because they can't shoulder a large share of their bill.\u003c/p>\n\u003cp>High deductibles, as well as high premiums and co-pays, \"serve as a deterrent for people accessing health care,\" he said. (\u003cem>Impatient\u003c/em> reported on \u003ca href=\"http://www.scpr.org/blogs/health/2015/03/11/17979/high-deductible-plans-hidden-costs-obvious-frustra/\">this phenomenon\u003c/a> last week.)\u003c/p>\n\u003cp>This situation is compounded by the fact that many people who are newly insured with cheaper higher-deductible plans \"don't have a lot of experience with the intricacies of the health care system,\" said Neeraj Sood, director of research for USC's Schaeffer Center for Health Policy & Economics.\u003c/p>\n\u003cp>They might know that they should ask the price of a procedure, but patients are \"intimidated to find out how much something is going to cost,\" he said.\u003c/p>\n\u003cp>Sood said he's heard that people can't afford their co-pays and deductibles, and are going into medical debt. And that's a problem both for patients and for doctors, who aren't getting paid.\u003c/p>\n\u003cp>\u003cstrong>'The Future is Here'\u003c/strong>\u003c/p>\n\u003cp>It was against this backdrop that our partner, Jeanne Pinder, founder and CEO of ClearHealthCosts.com, shared a more optimistic perspective: \"The future is here,\" she told the committee. \"People are actually shopping for health care.\"\u003c/p>\n\u003cp>She explained that hundreds and hundreds of people have shared their health costs with #PriceCheck. The reason?\u003c/p>\n\u003cp>\"People are really upset about the lack of cost transparency in the health care system,\" she said. \"They want to talk about it and they want a way to make a difference.\"\u003c/p>\n\u003cp>For the most part, she said, it's women who are doing the bulk of this health care shopping. They're the ones making most health-related decisions -- regarding reproductive health, kids' health, elder care -- and they're the ones who are on board with searching for affordable health care, added Pinder.\u003c/p>\n\u003cp>\u003cstrong>Relaunching PriceCheck\u003c/strong>\u003c/p>\n\u003cp>If you're upset about health costs, we have more good news for you: Starting next month, we are re-launching #PriceCheck. More details about that coming soon!\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In the meantime, if you've paid an arm and a leg for a recent procedure, tell us about it in the comments section below.\u003c/p>\n\n\u003c/div>\u003c/p>",
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},
"californiareport": {
"id": "californiareport",
"title": "The California Report",
"tagline": "California, day by day",
"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-California-Report-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/californiareport",
"meta": {
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"source": "kqed",
"order": 8
},
"link": "/californiareport",
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}
},
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"id": "californiareportmagazine",
"title": "The California Report Magazine",
"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
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"officialWebsiteLink": "/californiareportmagazine",
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"order": 10
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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"rss": "https://ww2.kqed.org/news/tag/tcrmag/feed/podcast"
}
},
"city-arts": {
"id": "city-arts",
"title": "City Arts & Lectures",
"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
"officialWebsiteLink": "https://www.cityarts.net/",
"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
"site": "news",
"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
"subscribe": {
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"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
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"info": "Close All Tabs breaks down how digital culture shapes our world through thoughtful insights and irreverent humor.",
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"officialWebsiteLink": "/podcasts/closealltabs",
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"order": 1
},
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"id": "code-switch-life-kit",
"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"meta": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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}
},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"meta": {
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"freakonomics-radio": {
"id": "freakonomics-radio",
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"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
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},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/381444908/podcast.xml"
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"here-and-now": {
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"officialWebsiteLink": "https://www.npr.org/series/423302056/hidden-brain",
"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
"id": "how-i-built-this",
"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
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"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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"amazon": "https://music.amazon.com/podcasts/6c3dd23c-93fb-4aab-97ba-1725fa6315f1/hyphenaci%C3%B3n",
"rss": "https://feeds.megaphone.fm/KQINC2275451163"
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"order": 18
},
"link": "/podcasts/jerrybrown",
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"apple": "https://itunes.apple.com/us/podcast/id1492194549",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/latino-usa",
"subscribe": {
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
"subscribe": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"spotify": "https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x",
"tuneIn": "https://tunein.com/radio/On-Our-Watch-p1436229/",
"stitcher": "https://www.stitcher.com/show/on-our-watch",
"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
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